Individual
MISS CHASITY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
405 BELCHER ST, CENTREVILLE, AL 35042-2946
(205) 926-2992
(205) 316-7675
Mailing address
405 BELCHER ST, CENTREVILLE, AL 35042-2946
(205) 926-2992
(205) 316-7675
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.1165
AL
Other
Enumeration date
09/27/2016
Last updated
11/27/2023
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