Individual
MRS. LESLIE MASON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
472 KLUTEY PARK PLAZA DR, HENDERSON, KY 42420-3348
(270) 826-3951
Mailing address
1501 BRECKENRIDGE ST, OWENSBORO, KY 42303-1054
(270) 686-7747
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2278
KY
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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