Individual
MRS. MYRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1377 MOHICAN DR, BIRMINGHAM, AL 35214-3811
(205) 705-6104
(205) 637-7848
Mailing address
1377 MOHICAN DR, BIRMINGHAM, AL 35214-3811
(205) 705-6104
(205) 637-7848
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
16003458
AL
Other
Enumeration date
01/22/2016
Last updated
01/22/2016
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