NPI 1104477546

Alisha Clark

Practitioner Driver Indianapolis, IN

Practice location

Address: 3907 Elmonte CT, Indianapolis, IN 46226-5536
Phone: (602) 814-7212

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1104477546
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Sep 2019
Record last updated: 26 Sep 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.