Individual
BONNIE J CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
47 CATON RD, CORNING, NY 14830-3741
(607) 937-4385
Mailing address
47 CATON RD, CORNING, NY 14830-3741
(607) 937-4385
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
217212-1
NY
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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