Individual
SUSANNAH J. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
275 VARNUM AVE STE 203, LOWELL, MA 01854-2109
(978) 458-4300
(978) 458-4311
Mailing address
275 VARNUM AVE STE 203, LOWELL, MA 01854-2109
(978) 458-4300
(978) 458-4311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3930
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110121498A
—
MA
Enumeration date
02/25/2010
Last updated
03/07/2025
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