Individual
CHRISTINA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1509 LOUISVILLE RD, HARRODSBURG, KY 40330-8622
(859) 239-2379
(859) 239-6898
Mailing address
PO BOX 990, DANVILLE, KY 40423-0990
(859) 239-2379
(859) 239-6898
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA482
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95000741
—
KY
Enumeration date
10/23/2006
Last updated
12/02/2020
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