National Provider Identifier

Tony L Clark

Tony L Clark is listed in the NPPES registry with a primary specialty of Integrative Medicine Physician in Rochester, NY and a listed phone number of (315) 480-4921.

NPI 1700611084Rochester, NYIntegrative Medicine Physician

Profile Overview

NPI
1700611084
Provider Type
Individual
Primary Specialty
Integrative Medicine Physician
Enumeration Date
September 05, 2024
Last Updated
September 05, 2024

Practice Location

  • 2509 Browncroft Blvd Ste 209
  • Rochester, NY 14625-1545

Phone: (315) 480-4921

Specialties

  • Integrative Medicine Physician (202D00000X)
Full Record
NPI
1700611084
Entity Type
Individual
Last Name
Clark
First Name
Tony
Middle Name
L
Mailing Street Address
2509 Browncroft Blvd Ste 209
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14625-1545
Mailing Country
US
Mailing Phone
(315) 480-4921
Practice Street Address
2509 Browncroft Blvd Ste 209
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14625-1545
Practice Country
US
Practice Phone
(315) 480-4921
Enumeration Date
September 05, 2024
Last Updated
September 05, 2024
Sex
Male
Sole Proprietor
Yes
Certification Date
September 05, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Integrative Medicine Physician (202D00000X)