Individual
HUNTER KELSEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
809 LAMONT ST, JOHNSON CITY, TN 37604-5453
(423) 306-1716
Mailing address
1208 FREDERICKSBURG DR, JOHNSON CITY, TN 37604-6376
(423) 306-1716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
218160
TN
Other
Enumeration date
03/21/2021
Last updated
03/21/2021
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