Individual
NATASHA K CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
231 E GRAHAM AVE, PRYOR, OK 74361-2436
(918) 825-1405
Mailing address
7015 E 618 RD, PEGGS, OK 74452-2079
(918) 882-2684
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
37V136193062
OK
Other
Enumeration date
12/30/2024
Last updated
12/30/2024
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