Individual
MRS. DONITA J CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
3 E APPLEBY RD STE 202, FAYETTEVILLE, AR 72703-4424
(479) 404-1140
(479) 404-1141
Mailing address
PO BOX 550, LOWELL, AR 72745
(479) 463-7775
(479) 463-7187
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
831
AR
Other
Enumeration date
10/28/2008
Last updated
10/03/2017
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