Individual
GANIECE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHLEBOTOMIST
Contact information
Practice address
891 SW HAMBERLAND AVE, PORT SAINT LUCIE, FL 34953-5629
(954) 696-6980
Mailing address
891 SW HAMBERLAND AVE, PORT SAINT LUCIE, FL 34953-5629
(954) 696-6980
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
FL
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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