Individual
ALEX CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
363 MCKNIGHT AVE, WEST FORK, AR 72774-7277
(479) 839-3035
Mailing address
PO BOX 419, WEST FORK, AR 72774-0419
(479) 839-3035
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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