Individual
CLARK TUDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
WRAPAROUND
Contact information
Practice address
2020 BROWN ST, ANDERSON, IN 46016-4218
(317) 574-1254
(317) 674-0060
Mailing address
9615 E 148TH ST STE 1, NOBLESVILLE, IN 46060-4371
(175) 741-2543
(317) 674-0060
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
09/03/2024
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