Individual
ISIDRO CLARA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
62226 COUNTY ROAD 15, GOSHEN, IN 46526-9438
(574) 875-5117
Mailing address
PO BOX 843, GOSHEN, IN 46527-0843
(574) 875-5117
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33011586A
IN
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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