Individual
MARTY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2501 KENTUCKY AVE, PADUCAH, KY 42003-3813
(270) 575-2598
Mailing address
291 KENNETH LN, HICKORY, KY 42051-9558
(270) 705-4684
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3016751
KY
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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