Individual
AUTUMN CONLEY-CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1025 S TRIMBLE RD, MANSFIELD, OH 44906-3427
(419) 529-4602
Mailing address
2011 WILLOWOOD CT, ONTARIO, OH 44906-1759
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.124514
OH
Other
Enumeration date
11/29/2022
Last updated
11/29/2022
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