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1790175990
JALITA LAUREN CLARK
COLUMBUS, GA
NPI
1790175990
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Former Name
JALITA LAUREN DANIEL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: GA LPN070344)
Enumeration Date
2015-01-27
Last Update Date
2015-01-27
Business Address
-- JALITA LAUREN CLARK LPN
2100 COMER AVE
COLUMBUS, GA 31904-8725
Phone number: 706-596-5583
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Mailing Address
-- JALITA LAUREN CLARK LPN
127 TWELVE OAKS DR
LAGRANGE, GA 30241-9647
Phone number: 912-614-8555
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