TERRELL TYRONE CLARK

LOUISA, KY
NPI1518722305
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
Enumeration Date2024-02-20
Last Update Date2024-02-20
Business Address
TERRELL TYRONE CLARK PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-639-0938
Mailing Address
TERRELL TYRONE CLARK PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-639-0938