Individual
D CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1412 GARFIELD AVE, SIDNEY, OH 45365-1726
(937) 658-4211
Mailing address
1412 GARFIELD AVE, SIDNEY, OH 45365-1726
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/17/2014
Last updated
02/15/2017
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