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1336552629
JACQUELINE CLARK
BOSTON, MA
NPI
1336552629
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MA 1867)
Enumeration Date
2014-06-04
Last Update Date
2014-06-04
Business Address
-- JACQUELINE CLARK ATC, CSCS
550 HUNTINGTON AVE
BOSTON, MA 02115-5901
Phone number: 617-989-4144
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Mailing Address
-- JACQUELINE CLARK ATC, CSCS
47 PARAGON RD UNIT 2
WEST ROXBURY, MA 02132-5127
Phone number: 617-759-2912
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