MRS. Shanta Lynn Clark, P.A.-C

NPI #1790169688 in Dowagiac, Michigan

Provider Information

NPI Number: 1790169688
Entity Type: Individual
Name: MRS. Shanta Lynn Clark, P.A.-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.-C
Enumeration Date: Jul 10, 2015
Last Updated: Jul 10, 2015

Practice Location

Address: 58620 SINK RD
Address 2: POKAGON HEALTH SERVICES
City: Dowagiac
State: Michigan
ZIP Code: 49047-9329
Phone: (269) 782-4141

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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