Individual provider · Type 1 NPI
Vontisha Shavron Clark
Driver · Williston, ND
NPI number
1972490258
Active
Practice location
3315 2nd Ave E Apt 102
Williston, ND 58801-2815
Fax (701) 651-6625
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | CLA806348 (ND) |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
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About NPI 1972490258
Vontisha Shavron Clark's National Provider Identifier is 1972490258, issued on Jun 19, 2025. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Williston, ND. The record was last updated on Jun 19, 2025.