NPI 1386106375

Nicole Clark, HAIRLOSSSPECIALIST

Practitioner Prosthetist Long Beach, MS

Practice location

Address: 100 N Burke Ave, Long Beach, MS 39560-4605
Phone: (228) 234-1658

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Registry record

NPI: 1386106375
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Apr 2019
Record last updated: 1 Apr 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.