Madison Jade Clark

NPI #1003506361 in Wilburton, Oklahoma

Provider Information

NPI Number: 1003506361
Entity Type: Individual
Name: Madison Jade Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: May 10, 2023
Last Updated: May 10, 2023

Practice Location

Address: 116 E MAIN ST STE B
City: Wilburton
State: Oklahoma
ZIP Code: 74578-4230
Phone: (918) 407-2662

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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