Erica Dominique Clack
NPI #1639734502 in San Augustine, Texas
Provider Information
- NPI Number
- 1639734502
- Entity Type
- Individual
- Name
- Erica Dominique Clack
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Licensed Vocational Nurse
- Enumeration Date
- May 7, 2019
- Last Updated
- May 7, 2019
Practice Location
- Address
- 406 E PLANTERS ST
- City
- San Augustine
- State
- Texas
- ZIP Code
- 75972-2140
- Phone
- (936) 201-2132
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Vocational Nurse |
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