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Individual

PATRICIA SUSAN CLARK

Active
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Individual

PATRICIA SUSAN CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
38938
CA
225100000X
Physical Therapist
CP010044T
WA
225100000X
Physical Therapist
Primary
CP014731T
GA
225100000X
Physical Therapist
PTL.0018065
CO

Other

Enumeration date
01/03/2022
Last updated
08/24/2022
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