Individual
TERALEA M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7701 LAKE WORTH RD, LAKE WORTH, FL 33467-2536
(561) 439-8821
(561) 439-5035
Mailing address
PO BOX 406153, ATLANTA, GA 30384-1876
(561) 478-8770
(561) 688-8877
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS2652
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
610124100
—
FL
Enumeration date
09/20/2006
Last updated
10/15/2008
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