Individual
JAYME MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2800 TAMARACK AVE, SUITE 104, SOUTH WINDSOR, CT 06074-5539
(860) 648-4480
(860) 648-2132
Mailing address
PO BOX 3252, VERNON, CT 06066-2152
(860) 896-1422
(860) 896-1425
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002685
CT
Other
Enumeration date
12/23/2011
Last updated
11/30/2012
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