| Doctor Name: | DR. AMY CHRISTINE CLARK |
| NPI Number: | 1649595174 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | 5101018785 |
| Business Practice Address: | 155 Calle Portal Suite 300 Sierra Vista, AZ - 856352900 |
| Business Phone Number: | 5204593011 |
| Business Fax Number: | 5204584457 |
| Mailing Address: | 155 Calle Portal, Suite 100 SIERRA VISTA |
| State: | AZ |
| Postal Code: | 856352900 |
| Phone Number: | 5204593012 |
| Fax Number: | 5205158663 |
| NPI Enumeration Date: | 03/26/2010 |
| NPI Last Update Date: | 03/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101018785 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |