Search › Arizona › 171W00000X
Shannon Clark
NPI 1700940855 · on the registry since 2006 · sole proprietor
Practice
- Address
- 12729 S Ox Cart Trl
Vail, AZ 85641 - Phone
- (512) 214-2841
- Fax
- (520) 750-0056
Registry record
- Primary taxonomy
- 171W00000X
171W00000X
- Licence states on file
- AZ
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-12-26
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 Arizona