Individual
MARY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2957 BROGDON RD, ALCOLU, SC 29001-8637
(202) 403-7850
Mailing address
2957 BROGDON RD, ALCOLU, SC 29001-8637
(202) 403-7850
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
3205095
DC
Other
Enumeration date
04/01/2014
Last updated
04/01/2014
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