Individual
MRS. RACHEL NACOLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-7800
Mailing address
13005 ARLINGTON RD, NEWBURG, MO 65550-9063
(573) 465-2268
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2018001797
MO
Other
Enumeration date
02/01/2018
Last updated
02/01/2018
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