Individual
MS. SUZANA IRENE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
100 ANTRIM BLVD, TANEYTOWN, MD 21787-2277
(410) 756-6400
(410) 756-5173
Mailing address
100 ANTRIM BLVD, TANEYTOWN, MD 21787-2277
(410) 756-6400
(410) 756-5173
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A2412
MD
Other
Enumeration date
06/15/2013
Last updated
06/15/2013
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