Individual
MS. ANDREA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 SEAMAN ST, APT. 101, TOLEDO, OH 43605-1952
(419) 810-2055
Mailing address
2300 SEAMAN ST, APT. 101, TOLEDO, OH 43605-1952
(419) 810-2055
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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