Individual
DENNIS ERIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 W MCDONALD ST, EDGERTON, KS 66021-2430
(913) 882-9704
Mailing address
112 W MCDONALD ST, EDGERTON, KS 66021-2430
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13-86682-081
KS
163W00000X
Registered Nurse
2009001167
MO
Other
Enumeration date
11/19/2009
Last updated
11/19/2009
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