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1376817221
TIFFANY LEAH CLACK
DALLAS, TX
NPI
1376817221
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: TX 765246)
Enumeration Date
2012-02-23
Last Update Date
2022-03-30
Business Address
TIFFANY LEAH CLACK MSN-ANP
712 N. WASHINGTON AVE SUITE 415
DALLAS, TX 75246-1800
Phone number: 214-820-9115
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Mailing Address
TIFFANY LEAH CLACK MSN-ANP
712 N WASHINGTON AVE SUITE 415
DALLAS, TX 75246-1619
Phone number: 214-820-9115
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