Individual
CHRISTINE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 W NIFONG BLVD, BLDG 6 STE 220B, COLUMBIA, MO 65203-5615
(573) 442-1690
(573) 442-1804
Mailing address
1000 W NIFONG BLVD, BLDG 6 STE 220B, COLUMBIA, MO 65203-5615
(573) 442-1690
(573) 442-1804
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2008028854
MO
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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