Individual
EMILY MOSSOTTI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1218 S BROADWAY, SUITE 310, LEXINGTON, KY 40504-2759
(859) 219-0542
(859) 219-9433
Mailing address
1218 S BROADWAY, SUITE 310, LEXINGTON, KY 40504-2759
(859) 219-0542
(859) 219-9433
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA991
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100051790
—
KY
Enumeration date
01/24/2008
Last updated
11/04/2011
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