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KORAH ELIZABETH CLARK

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1952878910

Individual Registrant:
 KORAH ELIZABETH CLARK 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
72 CRAFTWAY DR  HAWKINSVILLE, GA 31036-5813 US
Tel: 478-230-2453  Fax: --

Contact information for business:
72 CRAFTWAY DR  HAWKINSVILLE, GA 31036-5813 US
Tel: --  Fax: --

Registration Information:
NPI: 1952878910
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
Y390200000XStudent
Organized Health Care Education/Training Program

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
AMERICAN RED CROSSGU4NUL01




HEALTH CARE JOBS GA - Page 1



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