Individual
KATHY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAT
Contact information
Practice address
303 PARKWAY DR NE, ATLANTA, GA 30312-1212
(678) 592-0935
(770) 234-5103
Mailing address
3286 STEEPLE DR, DECATUR, GA 30034-5479
(678) 592-0935
(770) 235-5103
Taxonomy
Speciality
Code
Description
License number
State
246QH0000X
Hematology Specialist/Technologist
Primary
—
—
246Z00000X
Other Specialist/Technologist
—
—
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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