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Individual

MRS. FRANCES JANE CLARKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
165 BROWN PL, BX, BRONX, OH 10454
(718) 292-4502
Mailing address
77WEST 174 STREET, BRONX, NY 10453
(917) 620-8922

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
992823291
MI

Other

Enumeration date
08/31/2016
Last updated
08/31/2016
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