Individual
THERESA S CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 N RALEIGH STREET C1, ANGIER, NC 27501-7547
(919) 331-0031
(919) 338-2627
Mailing address
800 N RALEIGH ST STE C1, ANGIER, NC 27501-8613
(919) 331-0031
(919) 338-2627
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
103209
NC
Other
Enumeration date
09/17/2007
Last updated
12/15/2010
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