Individual
BETHIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CVS DRIVE, WOONSOCKET, RI 02895
(612) 225-1534
Mailing address
1 CVS DRIVE, WOONSOCKET, RI 02895
(612) 225-1534
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP3286272
FL
Other
Enumeration date
11/08/2007
Last updated
10/13/2010
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