Individual
ALISHA VICTORIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2507 OLD SAINT AUGUSTINE RD, TALLAHASSEE, FL 32301-6209
(866) 466-2475
Mailing address
2507 OLD SAINT AUGUSTINE RD, TALLAHASSEE, FL 32301-6209
(866) 466-2475
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
E2027750
TX
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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