Individual
GLORY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7356 S STATE ROUTE 123, BLANCHESTER, OH 45107-9338
(937) 218-0971
Mailing address
7356 S STATE ROUTE 123, BLANCHESTER, OH 45107-9338
(937) 218-0971
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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