Individual
JULIA MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1455 MONTREAL RD, TUCKER, GA 30084-8100
(404) 778-3350
Mailing address
1455 MONTREAL RD, TUCKER, GA 30084-8100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11386
GA
Other
Enumeration date
12/09/2022
Last updated
09/25/2024
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