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Organization
NATURE COAST MIND BODY MEDICINE, LLC
Active
Organization
NATURE COAST MIND BODY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EILIS CLARK MD (MGRM)
(352) 631-7460
Entity
Organization
Contact information
Practice address
210 S SALISBURY TER, LECANTO, FL 34461-5104
(352) 631-7460
Mailing address
210 S SALISBURY TER, LECANTO, FL 34461-5104
(352) 631-7460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
07/02/2018
Last updated
01/04/2020
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