| NPI | 1902689581 |
|---|---|
| Doing Business As | CLARK FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | RUSSELL CLARK Owner 615-988-1109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-08-16 |