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Individual

JADEAN PAULINE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1216 E 10TH ST, PLANKINTON, SD 57368-2045
(605) 680-2477
Mailing address
1216 E 10TH ST, PLANKINTON, SD 57368-2045

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
SD

Other

Enumeration date
09/19/2023
Last updated
09/19/2023
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