Individual
ELISABETH DANIELLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
106A SARALAND LOOP, SARALAND, AL 36571-2419
(251) 675-3333
Mailing address
11551 KALI OKA RD, EIGHT MILE, AL 36613-8729
(334) 360-1155
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S13072
AL
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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