Individual provider · Type 1 NPI
Madison Rae Clark
Student in an Organized Health Care Education/Training Program · Independence, MO
Practice location
15413 E 3rd Ter S
Independence, MO 64050-2289
Mailing address
411 Central Methodist Sq
Fayette, MO 65248-1104
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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About NPI 1821531492
Madison Rae Clark's National Provider Identifier is 1821531492, issued on Nov 29, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Independence, MO. The record was last updated on Dec 1, 2016.