Individual
JAN ELLEN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3441 E COLONIAL DR, STE F-32, ORLANDO, FL 32803-5113
(407) 206-5703
(407) 206-5704
Mailing address
8001 S ORANGE BLOSSOM TRL, FL MALL SUITE 692, ORLANDO, FL 32809-7654
(407) 859-7005
(407) 850-2635
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS4375
FL
Other
Enumeration date
11/20/2008
Last updated
10/06/2009
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