Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MISS NICOLE TM CLARK, ATC-L
ActiveSports Medicine (EM) · PORTLAND, ME
Registration Details
- NPI Number
- 1841609484
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 7, 2014 (11.707253171552 yrs)
- Last Updated
- Aug 7, 2014
- License
-
AT511 (ME)
Practice Information
- Address
-
267 OCEAN AVEPORTLAND, ME, 041035707Browse ME providers · Browse ZIP 04103
- Phone
- 2075428233
- Primary Specialty
-
Sports Medicine (EM)
207PS0010X
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.