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Mrs. Shannon Jackie Clark
Contractor in Vail, Arizona
NPI 1700940855

Shannon Jackie Clark is a Contractor based in Vail, AZ. Shannon Jackie Clark practices in Vail, AZ. The NPI Number for Shannon Jackie Clark is 1700940855 and holds a License No. 11816 (Arizona).

The current practice location address for Shannon Jackie Clark is 12729 S Ox Cart Trl, Vail, AZ and can be reached out via phone at 512-214-2841 and via fax at 520-750-0056.

Location: 12729 S Ox Cart Trl, Vail, AZ, 85641-9232
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700940855
Provider Name
Shannon Jackie Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
12729 S Ox Cart Trl, Vail, AZ, 85641-9232
Phone Number
512-214-2841
Fax Number
520-750-0056
Provider Enumeration Date
12/21/2006
Last Update Date
01/18/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
162753 05 AZ
institution
Provider Business Practice Location Address Details
Address
12729 S Ox Cart Trl
City
Vail
State
Arizona
Zip
85641-9232
Phone Number
512-214-2841
Fax Number
520-750-0056
person
Provider Business Mailing Address Details
Address
12729 S Ox Cart Trl
City
Vail
State
Arizona
Zip
85641-9232
Phone Number
512-214-2841
Fax Number
520-750-0056
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Contractor
Speciality
-
Taxonomy
171W00000X
License No.
11816 (Arizona)
Definition
A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).
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