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Individual

KELLY J CLARK

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6516
(570) 271-5814
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6516
(570) 271-5814

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
81665
MA
2084P0800X
Psychiatry Physician
Primary
MD458823
PA

Other

Enumeration date
06/02/2006
Last updated
02/19/2026
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