Individual
MS. SHELLEY B CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
6520 SUNSCOPE DR, OCEAN SPRINGS, MS 39564-8690
(228) 875-1177
(228) 872-4009
Mailing address
6520 SUNSCOPE DR, OCEAN SPRINGS, MS 39564-8690
(228) 875-1177
(228) 872-4009
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PTA4100
MS
Other
Enumeration date
03/04/2015
Last updated
03/04/2015
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