Individual
MRS. CANDICE A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
152 S WASHINGTON ST, BELCHERTOWN, MA 01007-9604
(413) 530-3647
Mailing address
152 S WASHINGTON ST, BELCHERTOWN, MA 01007-9604
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN212758
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1300237
—
MA
Enumeration date
05/15/2014
Last updated
05/15/2014
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