Individual
MS. NANCY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
1300 BOYLSTON ST, HEALTH WORKS FITNESS CENTER, CHESTNUT HILL, MA 02467
(617) 383-6100
(617) 795-1876
Mailing address
PO BOX 650124, 60 LINDBERGH AVE, WEST NEWTOWN, MA 02465
(617) 795-1875
(617) 795-1876
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
#736
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
402096
TUFTS HEALTH PLAN
MA
Enumeration date
10/11/2006
Last updated
07/08/2007
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