Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SANDRA CLARK, RT(R)
Active Sole ProprietorSANDRA CLARK, RT(R) is a 2471C3402X healthcare provider located in WATER VALLEY, Mississippi. NPI 1578692463 is currently active in the NPPES registry. Verify at CMS.
2471C3402X · WATER VALLEY, MS
Registration Details
- NPI Number
- 1578692463
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 5, 2007 (19.466012493366 yrs)
- Last Updated
- Jul 9, 2007
- License
-
MRT2279 (MS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
139 COUNTY ROAD 379WATER VALLEY, MS, 389653607Browse MS providers · Browse ZIP 38965
- Phone
- 6625145215
- Primary Specialty
-
2471C3402X
2471C3402X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.