Individual
JOSIE LANAI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1112 VERGES AVE, NORFOLK, NE 68701-3853
(308) 293-2504
Mailing address
902 ELM AVE, NORFOLK, NE 68701-3948
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2320
NE
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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