Search › West Virginia › 171M00000X
Jessica Clark
NPI 1649156936 · on the registry since 2025 · sole proprietor
Practice
- Address
- 1519 Mary Lou Retton Dr
Fairmont, WV 26554 - Phone
- (304) 282-5582
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Licence states on file
- WV
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-08-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in West Virginia