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General NPI Number Information
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NPI Number | 1528951290
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Entity Type | Organization
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Legal Business Name | CLARK WELLNESS, LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 5601 N ORACLE RD STE 121
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City | TUCSON
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State | AZ
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Zip | 85704-3982
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Country | US
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Telephone | 520-526-1258
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Fax | 520-542-3737
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Provider Business Mailing Address
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Address Line | 8193 N STONEHILL DR
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City | TUCSON
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State | AZ
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Zip | 85743-1437
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Country | US
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Telephone | 520-526-1258
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Fax | 520-542-3737
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/OWNER
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Name | ASHLEY CLARK
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Credential | NP
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Telephone | 520-526-1258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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