Individual
DIAMOND L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2918 AMBARWENT RD, REYNOLDSBURG, OH 43068-7059
(614) 778-4717
Mailing address
2918 AMBARWENT RD, REYNOLDSBURG, OH 43068-7059
(614) 778-4717
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
169152
OH
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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