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Contact Information

MARY CLARK
203 N PAGE ST
CHESTERFIELD, SC29709-1201
 Phone: 843-623-2206
 Fax: 843-623-2469
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

163WH0200X
Indicates primary specialty

NPI Profile & details for MARY CLARK · (Female)

NPI Number 1407274194
Status Active
Credentials
Entity Individual
Enumeration date 03/31/2014
Last updated 03/31/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • SC License # 37156
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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