Individual
SEONTA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10228 CHARLESTON RD, RED HOUSE, WV 25168-7511
(681) 587-4418
Mailing address
10228 CHARLESTON RD, RED HOUSE, WV 25168-7511
(681) 587-4418
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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