National Provider Identifier
Theresa Clark
Theresa Clark is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Ontario, NY and a listed phone number of (585) 831-1829.
Profile Overview
- NPI
- 1588118665
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- August 07, 2016
- Last Updated
- August 07, 2016
Practice Location
- 6541 Furnace RD
- Ontario, NY 14519-9701
Phone: (585) 831-1829
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1588118665
- Entity Type
- Individual
- Last Name
- Clark
- First Name
- Theresa
- Mailing Street Address
- 6541 Furnace RD
- Mailing City
- Ontario
- Mailing State
- NY
- Mailing ZIP Code
- 14519-9701
- Mailing Country
- US
- Mailing Phone
- (585) 831-1829
- Practice Street Address
- 6541 Furnace RD
- Practice City
- Ontario
- Practice State
- NY
- Practice ZIP Code
- 14519-9701
- Practice Country
- US
- Practice Phone
- (585) 831-1829
- Enumeration Date
- August 07, 2016
- Last Updated
- August 07, 2016
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)