Individual
JA'VON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
241 W GRANT ST, NEW CASTLE, PA 16101-2212
(724) 658-7258
(724) 658-7664
Mailing address
241 W GRANT ST, NEW CASTLE, PA 16101-2212
(724) 658-7258
(724) 658-7664
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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