Individual
IESHA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
795 S CHAMPION AVE, COLUMBUS, OH 43206-1509
(614) 432-1628
Mailing address
795 S CHAMPION AVE, COLUMBUS, OH 43206-1509
(614) 432-1628
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
OH
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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