Clark, Jerillyn Marie

Clark, Jerillyn Marie is an sole proprietor health care provider with primary practice located at 6441 W Norvell Bryant Hwy , Crystal River FL 34429-9413. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, which is considered as her primary health care specialty. Clark, Jerillyn Marie can be contacted via phone (352) 795-1775.

Contact Information

Primary practice address
6441 W Norvell Bryant Hwy Crystal River FL 34429-9413
Phone: (352) 795-1775
Fax: (352) 795-6456
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X AS2131 Florida

Profile Details

NPI number 1851406060
LBN Legal business name Clark, Jerillyn Marie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851406060 NPPES
Florida Other AS2131 HEARING AID LICENSE

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