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1205902236
MICAH SHEA CLARK
OAK RIDGE, TN
NPI
1205902236
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: TN 075331)
Enumeration Date
2006-11-28
Last Update Date
2007-07-08
Business Address
MICAH SHEA CLARK
990 OAK RIDGE TPKE
OAK RIDGE, TN 37830-6976
Phone number: 931-858-6303
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Mailing Address
MICAH SHEA CLARK
PO BOX 5059
OAK RIDGE, TN 37831-5059
Phone number: 770-237-1089
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