Individual
CORI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11 SHUTTLE RD, FARMINGTON, CT 06032-1900
(860) 679-3980
Mailing address
11 SHUTTLE RD, FARMINGTON, CT 06032-1900
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
75730
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2019
Last updated
08/11/2025
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