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Individual

MR. WILLIAM A CLARK

Active
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Individual

MR. WILLIAM A CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT001501E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50004079
CAPITAL BLUE CROSS
PA
01
—
CL551250
BLUE SHEILD
PA
Enumeration date
08/09/2005
Last updated
04/16/2025
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