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1902582141
ELIJAH ALEXANDER CLARK
LOUISA, KY
NPI
1902582141
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2023-06-23
Last Update Date
2023-06-23
Business Address
ELIJAH ALEXANDER CLARK
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
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Mailing Address
ELIJAH ALEXANDER CLARK
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
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