Individual
CYNTHIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12940 MORTONS CORNERS RD, SPRINGVILLE, NY 14141-9252
(716) 592-4174
Mailing address
12940 MORTONS CORNERS ROAD, SPRINGVILLE, NY 14141
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
002481-1
NY
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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