Individual
CHARLOTTE A. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 SE CROSS ST, MOUNT STERLING, IL 62353-1561
(217) 773-3325
(217) 773-2425
Mailing address
700 SE CROSS ST, MOUNT STERLING, IL 62353-1561
(217) 773-3325
(217) 773-2425
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.070144
IL
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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