Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 5101013445 | MI |
NPI | 1073527586 |
---|---|
Provider Name | Dawn Clark Barber |
First Address | Fountain Valley, CA 92728-8309 |
Second Address | Ludington, MI 49431-1906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 16/11/2021 |