Candie Clark
Durable Medical Equipment & Medical Supplies in Villa Rica, GA. Individual provider (NPI-1).
NPI number1619702289
StatusActive
Last updated in NPPESSep 4, 2024
Details
- NPI
- 1619702289
- Entity type
- Individual (NPI-1)
- Name
- Candie Clark
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 4, 2024
- Certification date
- Aug 12, 2024
- Last updated
- Sep 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
Practice location
1836 Carrollton Villa Rica Hwy Ste 301Villa Rica, GA 30180-5195
Phone 770-742-9375
Mailing address
1836 Carrollton Villa Rica Hwy Ste 301Villa Rica, GA 30180-5195
Phone 770-742-9375
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All 12 Durable Medical Equipment & Medical Supplies providers in Villa Rica · All 569 providers in Villa Rica
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