Organization
CLARK FAMILY PRACTICE LLC
Active
Other names
Clark Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ELISHA A CLARK APRN (OWENER)
(740) 680-1227
Entity
Organization
Contact information
Practice address
293 W MAIN ST, BYESVILLE, OH 43723-1137
(740) 680-1227
Mailing address
293 W MAIN ST, BYESVILLE, OH 43723-1137
(740) 680-1227
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056266
—
OH
Enumeration date
06/23/2022
Last updated
05/27/2025
Update your record
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