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Individual
KERI ANN CLARK
Active
Individual
KERI ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1170769
TX
2251P0200X
Pediatric Physical Therapist
PT 24019
FL
Other
Enumeration date
06/24/2008
Last updated
02/14/2011
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