Individual
MRS. CAMARINE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
163 WESTRIDGE CIR, DALLAS, GA 30132-9232
(404) 570-0670
Mailing address
163 WESTRIDGE CIR, DALLAS, GA 30132-9232
(404) 570-0670
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
093258
GA
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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