Individual
MS. JORDAN ELIZABETH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4156 BRISTOL HWY STE 4, JOHNSON CITY, TN 37601-3088
(859) 576-5997
Mailing address
2020 INDIAN RIDGE RD APT 85, JOHNSON CITY, TN 37604-4293
(859) 576-5997
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/11/2025
Last updated
12/12/2025
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