Individual
MARSHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
154 BLOUNTVILLE BYP, BLOUNTVILLE, TN 37617-4575
(423) 279-2777
(423) 279-2797
Mailing address
PO BOX 360, BLOUNTVILLE, TN 37617-0360
(423) 279-7557
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000050224
TN
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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