Individual
NATALIE LOREE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
460 W 10TH AVE FL 2, COLUMBUS, OH 43210-1240
(614) 293-3241
(614) 293-4044
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 366-9232
(614) 366-9217
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50007840RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002271
—
OH
Enumeration date
01/17/2022
Last updated
12/11/2023
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