Individual
MEGAN JO CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
8301 E PRENTICE AVE STE 125, GREENWOOD VILLAGE, CO 80111-2989
(303) 771-3939
(303) 771-4949
Mailing address
8301 E PRENTICE AVE STE 125, GREENWOOD VILLAGE, CO 80111-2989
(303) 771-3939
(303) 771-4949
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5014
AZ
363A00000X
Physician Assistant
PA.0003925
CO
363AM0700X
Medical Physician Assistant
Primary
PA.0003925
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982989885
NPI
—
Enumeration date
10/12/2011
Last updated
12/18/2018
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