Individual
DONNA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 MILLPOND RD, THOMASVILLE, GA 31792-7636
(229) 226-1621
Mailing address
97268 YORKSHIRE DR, YULEE, FL 32097-7362
(734) 678-6117
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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