Individual
ELIJAH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 HELTON DR APT 3123, COLUMBIA, SC 29229-6948
(803) 807-8894
(803) 807-8894
Mailing address
20 HELTON DR APT 3123, COLUMBIA, SC 29229-6948
(803) 807-8894
(803) 807-8894
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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