Individual
TARA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 GRILL RD, NEW FRANKLIN, OH 44216-9320
(330) 329-4408
Mailing address
540 GREAT OAKS TRL, WADSWORTH, OH 44281-8799
(330) 336-1141
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
3814
OH
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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