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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ELIAS GERRIT CLARK

Active Sole Proprietor

Medical Technologist · CEDAR RAPIDS, IA

Registration Details

NPI Number
1780949958
Provider Type
Individual
Gender
Male
NPI Issued
Jul 12, 2012 (13.779947792762 yrs)
Last Updated
Jul 12, 2012
License
240891 (IA)
Sole Proprietor
Yes

Practice Information

Address
531 COUNTRY HILL CT NE
APARTMENT 2
CEDAR RAPIDS, IA, 524028310
Browse IA providers · Browse ZIP 52402
Phone
6059299380
Primary Specialty
Medical Technologist
246QM0706X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.