Individual
MR. NICHOLAS SHEA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
1400 WASHINGTON AVE, ALBANY, NY 12222-0100
(518) 429-7113
Mailing address
61 HUDSON AVE APT 1, GREEN ISLAND, NY 12183-1171
(518) 429-7113
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003852
NY
Other
Enumeration date
12/13/2024
Last updated
12/30/2024
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