Individual
ANGELA G CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4703 HORTON RD, PLANT CITY, FL 33567-3625
(813) 808-9023
Mailing address
4703 HORTON RD, PLANT CITY, FL 33567-3625
(813) 808-9023
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
FL
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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