Individual
TAMMIE L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN BSN
Contact information
Practice address
1001 SOUTH MAIN, LAMAR, CO 81052
(719) 336-8721
(719) 336-9763
Mailing address
1001 SOUTH MAIN, LAMAR, CO 81052
(719) 336-8721
(719) 336-9763
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
111927
CO
Other
Enumeration date
08/09/2013
Last updated
08/09/2013
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