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Individual
SHARON V CLARK
Active
Individual
SHARON V CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
153-039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153-039
ATHLETIC TRAINER
WI
Enumeration date
07/21/2006
Last updated
07/08/2007
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