Individual
LYNETT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 MARKET ST STE 2, LEWISBURG, PA 17837-3002
(570) 524-0900
Mailing address
501 MARKET ST STE 2, LEWISBURG, PA 17837-3002
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN274671
PA
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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