Individual
PHYLLIS VERONICA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1375 E FILLMORE ST, COLORADO SPRINGS, CO 80907-6457
(719) 632-8845
Mailing address
1375 E FILLMORE ST, COLORADO SPRINGS, CO 80907-6457
(719) 632-8845
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
CO27522
CO
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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