Individual
HOLLIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 E MAIN ST, RUSSELLVILLE, AR 72801-5322
(479) 452-5040
(479) 452-5047
Mailing address
PO BOX 23070, BARLING, AR 72923-0070
(479) 452-5040
(479) 452-5047
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/22/2012
Last updated
06/22/2012
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