SearchSouth Carolina253Z00000X

Demetria Clark

NPI 1811777394 · on the registry since 2023 · sole proprietor

Practice

Address
4600 Fort Jackson Blvd Apt 124
Columbia, SC 29209
Phone
(803) 357-2268
Fax
(803) 887-5093

Registry record

Primary taxonomy
253Z00000X
253Z00000X
Licence states on file
SC
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-10-03

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 South Carolina