Individual
KATELYN ROSE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
605 E MAIN ST UNIT 19, BAY SHORE, NY 11706-8505
(631) 665-0795
Mailing address
605 E MAIN ST UNIT 19, BAY SHORE, NY 11706-8505
(631) 665-0795
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
14000053702
NY
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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