STACEY J. CLARKE DPM, PC
Podiatry at Hall St, Island City, OR

License number
Oregon DP00283
Category
Podiatry
Type
Podiatrist
Owner
Name: MRS. STACEY J CLARKE DPM
Title: OWNER
Phone: (541) 963-0265
Address
Address
1408 N Hall St, Island City, OR 97850
National Provider ID: 1558490763
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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STACEY J CLARKE, D.P.M., PC

1408 N Hall St, La Grande, OR 97850

Registration:
Aug 29, 1997
State ID:
58735284
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Agent:
Stacey Jclarke,1408 N Hall St, La Grande, OR 97850 (Physical)

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