Individual
KATELYN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 HOWARD AVE STE 1, ALTOONA, PA 16601-4728
(814) 889-2708
Mailing address
107 FOREST ST, GALLITZIN, PA 16641-1115
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA060775
PA
Other
Enumeration date
07/04/2019
Last updated
03/14/2023
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