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Individual

AMELIA JO CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PRSS

Contact information

Practice address
1729 NW 3RD ST, OKLAHOMA CITY, OK 73106-2810
(405) 246-0828
(405) 246-0828
Mailing address
1729 NW 3RD ST, OKLAHOMA CITY, OK 73106-2810
(405) 415-8410
(405) 415-8410

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
03/10/2022
Last updated
01/04/2024
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