Individual
BETH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
23 EDGEWATER PL, GLENS FALLS, NY 12801-4110
(518) 798-8699
Mailing address
23 EDGEWATER PL, GLENS FALLS, NY 12801-4110
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
500874-1
NY
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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