Individual
KAY ELAINE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
495 W MOHAWK DR, MALVERN, OH 44644-9652
(330) 936-3068
Mailing address
495 W MOHAWK DR, MALVERN, OH 44644-9652
(330) 936-3068
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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