Individual
DEBORAH LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1144 N ROAD ST, ELIZABETH CITY, NC 27909-3353
(252) 384-4133
(252) 384-4191
Mailing address
1213 RIVERSIDE AVE APT 104, ELIZABETH CITY, NC 27909-5456
(252) 384-4133
(252) 384-4191
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-00459
NC
Other
Enumeration date
07/10/2006
Last updated
12/10/2009
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