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Dr. Katie Marie Clark, DO
Student in an Organized Health Care Education/Training Program in Fairborn, Ohio
NPI 1457047490

Katie Marie Clark is a Student in an Organized Health Care Education/Training Program based in Fairborn, OH. Katie Marie Clark practices in Fairborn, OH and has the professional credentials of DO. The NPI Number for Katie Marie Clark is 1457047490 and holds a License No. (Ohio).

The current practice location address for Katie Marie Clark is 2555 University Dr, Fairborn, OH and can be reached out via phone at 937-775-7792.

Location: 2555 University Dr, Fairborn, OH, 45324-6255
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457047490
Provider Name
Katie Marie Clark
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
2555 University Dr, Fairborn, OH, 45324-6255
Phone Number
937-775-7792
Fax Number
Provider Enumeration Date
04/13/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2555 University Dr
City
Fairborn
State
Ohio
Zip
45324-6255
Phone Number
937-775-7792
Fax Number
person
Provider Business Mailing Address Details
Address
2555 University Dr
City
Fairborn
State
Ohio
Zip
45324-6255
Phone Number
937-775-7792
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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