Shelby Clark

NPI #1013436518 in Mangum, Oklahoma

Provider Information

NPI Number: 1013436518
Entity Type: Individual
Name: Shelby Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician
Enumeration Date: Sep 15, 2017
Last Updated: Sep 15, 2017

Practice Location

Address: 400 N PENNSYLVANIA AVE
City: Mangum
State: Oklahoma
ZIP Code: 73554-3034
Phone: (580) 782-3371

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician	374700000X	Primary

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