Individual
STEPHANIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
3 PARK AVE, LONDONDERRY, NH 03053-3691
(603) 247-0474
Mailing address
3 PARK AVE, LONDONDERRY, NH 03053-3691
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3254
FL
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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