Individual
SALLY ANNE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
145 E CHEVES ST, FLORENCE, SC 29506-2526
(843) 661-4835
Mailing address
145 E CHEVES ST, DHEC, FLORENCE, SC 29506-2526
(843) 661-4835
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
RN75916
SC
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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