Individual
AMMIE NACOLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 ROBINSON RD BLDG BLOCKS, CLINTON, NY 13323-1418
(315) 853-6090
Mailing address
19 ROBINSON RD BLDG BLOCKS, CLINTON, NY 13323-1418
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1870597251
NY
Other
Enumeration date
02/26/2026
Last updated
02/26/2026
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