Individual
HOLLY D. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5583
(706) 596-5589
Mailing address
6216 FLAT ROCK RD, COLUMBUS, GA 31907-9214
(720) 731-4858
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/28/2009
Last updated
08/28/2009
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