Individual
MARY E CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 CHATEAU DR, MUNCIE, IN 47303-1900
(317) 354-6940
Mailing address
2400 CHATEAU DR, MUNCIE, IN 47303-1900
(317) 354-6940
Taxonomy
Speciality
Code
Description
License number
State
163WI0600X
Infection Control Registered Nurse
Primary
28236546A
IN
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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