Individual
SARAH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12024 LAMEY BRIDGE RD, DIBERVILLE, MS 39540-8906
(225) 933-0308
Mailing address
12024 LAMEY BRIDGE RD, DIBERVILLE, MS 39540-8906
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
297372
NC
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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