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Individual

LORI RENEE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
1201 HADLEY RD, MOORESVILLE, IN 46158-1737
(317) 528-8961
Mailing address
8015 THISTLE FINCH, BROWNSBURG, IN 46112-7768
(317) 965-0892

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
879437
IN

Other

Enumeration date
04/06/2018
Last updated
04/06/2018
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