Individual
ANGELA M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1121 BELLWEST BLVD, BELLEVILLE, WI 53508-9433
(608) 424-3384
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1497-23
WI
363AS0400X
Surgical Physician Assistant
1497
WI
Other
Enumeration date
04/22/2006
Last updated
11/08/2022
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