Individual
MIRIAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1844 COMMONWEALTH AVE, AUBURNDALE, MA 02466-2709
(617) 243-2451
Mailing address
1844 COMMONWEALTH AVE, AUBURNDALE, MA 02466-2716
(617) 243-2451
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2284844
MA
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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