Nicole Clark, LAT, ATC
NPI #1871968768 in Bloomfield, Indiana
Provider Information
- NPI Number
- 1871968768
- Entity Type
- Individual
- Name
- Nicole Clark, LAT, ATC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- LAT, ATC
- Enumeration Date
- Dec 3, 2015
- Last Updated
- Dec 3, 2015
Practice Location
- Address
- 332 WILSON DR
- City
- Bloomfield
- State
- Indiana
- ZIP Code
- 47424-1054
- Phone
- (317) 432-3861
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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