THERESA CARLISLE CLARK

PHENIX CITY, AL
NPI1003056383
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: GA  166504)
Enumeration Date2009-02-26
Last Update Date2009-02-26
Business Address
Ms. THERESA CARLISLE CLARK Registered Nurse
1900 CARRIAGE DR
PHENIX CITY, AL 36867-2116
Phone number: 706-289-9327
Mailing Address
Ms. THERESA CARLISLE CLARK Registered Nurse
1900 CARRIAGE DR
PHENIX CITY, AL 36867-2116
Phone number: 706-289-9327
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