Individual
EMMA CAROLINE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 E APPLE ST STE 6258, DAYTON, OH 45409-2939
(937) 208-2951
Mailing address
7845 SILVER LAKE CT, WESTERVILLE, OH 43082-8288
(614) 949-6041
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
57.254241
OH
Other
Enumeration date
03/23/2022
Last updated
04/24/2023
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