NPI 1912185927

Jason H Clark & Sandra J Clark

Organisation Portable X-ray and/or Other Portable Diagnostic Imaging Supplier Water Valley, MS

Practice location

Address: 139 County Road 379, Water Valley, MS 38965-3607
Phone: (662) 514-5215
Fax: (662) 234-0172
Mailing address: PO Box 994, Oxford, MS 38655-0994

Authorised official

Name: Jason Clark
Title: Owner
Phone: (662) 514-5215

Registered specialties

Portable X-ray and/or Other Portable Diagnostic Imaging Supplier Primary

Suppliers Taxonomy 335V00000X Licence MRT2279 (MS)

Other Portable X-ray and/or Other Portable Diagnostic Imaging Supplier providers in Mississippi →

Registry record

NPI: 1912185927
Entity type: Organization
NPI issued: 1 Feb 2008
Record last updated: 3 Dec 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.