Individual
MRS. ERIN D CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
11225 PINE BANK CT, FORT WAYNE, IN 46845-1841
(919) 247-2831
Mailing address
11225 PINE BANK CT, FORT WAYNE, IN 46845-1841
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001305A
IN
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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