Individual
MS. ELYSE E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
4400 VESTAL PARKWAY, BINGHAMTON UNIVERSITY EVENTS CENTER, BINGHAMTON, NY 13902-6000
(607) 777-2784
(607) 777-5577
Mailing address
202 N PAGE AVE, ENDICOTT, NY 13760-3936
(607) 239-4332
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001283-1
NY
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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