| NPI | 1083195283 |
|---|---|
| Doing Business As | CLARKSBURG FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | DEBRA SUE CANNON Owner 731-535-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2019-01-25 |