Individual
ANGELIQUE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
159 MAYLUTH RD, JOHNSTOWN, PA 15904-2632
(267) 240-9184
(267) 240-9184
Mailing address
159 MAYLUTH RD, JOHNSTOWN, PA 15904-2632
(267) 240-9184
(267) 240-9184
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN314105
PA
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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