Individual
JILL A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMT, NCTMB
Contact information
Practice address
54 C UTICA ST., HAMILTON, NY 13346
(607) 244-2790
Mailing address
54 C UTICA ST., HAMILTON, NY 13346
(607) 244-2790
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
022029
NY
Other
Enumeration date
11/03/2009
Last updated
11/03/2009
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