Individual provider · Type 1 NPI

Ryan Clark, PA

Medical Physician Assistant · Philadelphia, PA

NPI number 1962648121 Active

Practice location

5501 Old York Rd, Willlowcrest Bldg., 4th Floor
Philadelphia, PA 19141-3018

Call (215) 456-1754 Map

Mailing address

101 E Olney Ave, Suite 400
Philadelphia, PA 19120-2421

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XMA053613 (PA)

Medical Physician Assistant: Definition to come...

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About NPI 1962648121

Ryan Clark, PA's National Provider Identifier is 1962648121, issued on Dec 18, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Philadelphia, PA. The record was last updated on Dec 18, 2008.