Carolyn D Clark
Technician, Other in Memphis, TN. Individual provider (NPI-1).
NPI number1902691173
StatusActive
Last updated in NPPESApr 10, 2025
Details
- NPI
- 1902691173
- Entity type
- Individual (NPI-1)
- Name
- Carolyn D Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 10, 2025
- Certification date
- Apr 7, 2025
- Last updated
- Apr 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
116 N Pauline St # 11-HMemphis, TN 38104-1005
Phone 901-523-8990
Mailing address
116 N Pauline St # 11-HMemphis, TN 38104-1005
Phone 901-523-8990
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