Theresa S. Clark MSRD,C.D.E., L.D.

NPI 1013120948 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1013120948
Gender Female
Enumeration Date 05/07/2007
Last Updated 07/09/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
104 FORBES DR
HOPKINSVILLE KY, 42240-7200, US
Phone (270) 707-0060
Fax (270) 707-0068
Business Location
104 FORBES DR
HOPKINSVILLE KY, 42240-7200, US
Phone (270) 707-0060
Fax (270) 707-0068
Toxanomy
Taxonomy Code 133V00000X
License State Kentucky
License Number KY-0517
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According to our database, Mrs. Theresa S. Clark MSRD,C.D.E., L.D. NPI is 1013120948, taxonomy code is 133V00000X and license number is KY-0517, license state is located at Kentucky. Theresa S. Clark MSRD,C.D.E., L.D. physically located at 104 Forbes Dr, Hopkinsville KY, 42240-7200. NPI Number Theresa S. Clark MSRD,C.D.E., L.D. has the Individual type.

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1013120948 NPI number is provided on an as is basis without warranty of any kind. 1013120948 is maintained by the National Plan & Provider Enumeration System. The contents of Theresa S. Clark MSRD,C.D.E., L.D. are for informational purposes only.