Individual
MRS. ALONA ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2288 BUSHWICK DR, MORAINE, OH 45439-3108
(937) 474-6652
Mailing address
2288 BUSHWICK DR, MORAINE, OH 45439-3108
(937) 474-6652
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
145462
OH
Other
Enumeration date
01/24/2012
Last updated
01/12/2017
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