Clark, Ursula Lori

Clark, Ursula Lori is an individual health care provider with primary practice located at 4700 Rolling Pine Dr Apt D25 , Lake Park GA 31636-4935. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Clark, Ursula Lori can be contacted via phone (305) 877-6401.

Contact Information

Primary practice address
4700 Rolling Pine Dr Apt D25 Lake Park GA 31636-4935
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X

Profile Details

NPI number 1710562129
LBN Legal business name Clark, Ursula Lori
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2021
Last updated Mar 17th, 2021 - about 4 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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