Individual
SHANA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
609 PARK SPRINGS BLVD, SPRING CITY, PA 19475-1646
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
10001837
PA
Other
Enumeration date
03/16/2009
Last updated
03/16/2009
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