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1174080873
MIRANDA CLARK
TYLER, TX
NPI
1174080873
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164X00000X Licensed Vocational Nurse
(Licence: TX 318488)
Enumeration Date
2019-02-28
Last Update Date
2019-02-28
Business Address
MIRANDA CLARK
9846 HWY 31 E
TYLER, TX 75705-2329
Phone number: 903-525-8001
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Mailing Address
MIRANDA CLARK
9846 HWY 31 E
TYLER, TX 75705-2329
Phone number: 903-525-8001
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