NPI 1730704750

Clarissa Charles

Practitioner Prosthetist Highland, IN

Practice location

Address: 2715 Main St STE D, Highland, IN 46322-3637
Phone: (708) 341-4457
Mailing address: PO Box 1905, Highland, IN 46322

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence BR020426 (GA)

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Registry record

NPI: 1730704750
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Jun 2020
Record last updated: 5 Oct 2020

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.