| Doctor Name: | DR. JANICE PATRECE CLARK |
| NPI Number: | 1811168339 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPM |
| License Number: | R57676 |
| Business Practice Address: | 201 N 21 B Avenue Zuni, NM - 87327 |
| Business Phone Number: | 5057822255 |
| Business Fax Number: | |
| Mailing Address: | Po Box 467, ZUNI |
| State: | NM |
| Postal Code: | 873270467 |
| Phone Number: | 2108426826 |
| Fax Number: | 5057827330 |
| NPI Enumeration Date: | 03/13/2008 |
| NPI Last Update Date: | 03/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | R57676 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |