Individual provider · Type 1 NPI

Jordan McKenzie Clark

Student in an Organized Health Care Education/Training Program · Malone, NY

NPI number 1831035955 Active

Practice location

125 Finney Blvd
Malone, NY 12953-1067

Call (518) 481-8160 Map

Fax (518) 481-8161

Mailing address

324 County Route 51 Bldg 1
Malone, NY 12953-4502

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone 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 1831035955

Jordan McKenzie Clark's National Provider Identifier is 1831035955, issued on Apr 29, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Malone, NY. The record was last updated on Apr 29, 2026.