Individual
MELINDA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1145 GOLDEN VALLEY CT, LAWRENCEVILLE, GA 30043-6372
(706) 769-1010
Mailing address
PO BOX 491832, LAWRENCEVILLE, GA 30049-0031
(706) 769-1010
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0030009090
GA
Other
Enumeration date
04/01/2021
Last updated
04/21/2021
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