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Individual

LORA J CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, ATC

Contact information

Practice address
406 COLUMBIA ST, HARRISBURG, SD 57032
(605) 359-9506
Mailing address
PO BOX 436, HARRISBURG, SD 57032-0436

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
04/15/2009
Last updated
01/28/2015
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