Clark, Terrell Tyrone

Clark, Terrell Tyrone is an sole proprietor health care provider with primary practice located at 125 S Main Cross St , Louisa KY 41230-1065. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Clark, Terrell Tyrone can be contacted via phone (606) 639-0938.

Contact Information

Primary practice address
125 S Main Cross St Louisa KY 41230-1065
Phone: (606) 639-0938
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1518722305
LBN Legal business name Clark, Terrell Tyrone
Credentials PSS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 20th, 2024
Last updated Feb 20th, 2024 - about last year

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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