Individual
LORIS E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16940 SLOVER AVE STE A, FONTANA, CA 92337-7566
(909) 854-8569
Mailing address
5000 CHESHIRE PKWY N, PLYMOUTH, MN 55446-4103
(763) 268-4115
(763) 268-4017
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
AU2023
CA
237600000X
Audiologist-Hearing Aid Fitter
Primary
AU2023
CA
Other
Enumeration date
02/07/2008
Last updated
01/28/2020
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