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Madison Jade Clark
Student in an Organized Health Care Education/Training Program in Wilburton, Oklahoma
NPI 1003506361

Madison Jade Clark is a Student in an Organized Health Care Education/Training Program based in Red Oak, OK. Madison Jade Clark practices in Wilburton, OK. The NPI Number for Madison Jade Clark is 1003506361 and holds a License No. (Oklahoma).

The current practice location address for Madison Jade Clark is 116 E Main St Ste B, Wilburton, OK and can be reached out via phone at 918-407-2662.

Location: 116 E Main St Ste B, Wilburton, OK, 74563-0058
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003506361
Provider Name
Madison Jade Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
116 E Main St Ste B, Wilburton, OK, 74563-0058
Phone Number
918-407-2662
Fax Number
Provider Enumeration Date
05/10/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
116 E Main St Ste B
City
Wilburton
State
Oklahoma
Zip
74578-4230
Phone Number
918-407-2662
Fax Number
person
Provider Business Mailing Address Details
Address
116 E Main St Ste B
City
Wilburton
State
Oklahoma
Zip
74578-4230
Phone Number
918-407-2662
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
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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