Individual
MRS. CAROL W CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
600 SOUTH DRIVE, FORT COLLINS, CO 80523
(970) 491-7121
Mailing address
600 SOUTH DRIVE, FORT COLLOINS, CO 80523
(970) 491-7121
Taxonomy
Speciality
Code
Description
License number
State
163WC1400X
College Health Registered Nurse
Primary
84-6000-545
CO
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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