Individual
ERIKA LEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
800 UNIVERSITY DR, MARYVILLE, MO 64468-6015
(660) 562-1313
Mailing address
800 UNIVERSITY DR, MARYVILLE, MO 64468-6015
(660) 562-1313
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2012026115
MO
Other
Enumeration date
05/02/2013
Last updated
05/02/2013
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