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Individual

SHELLEY CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
2803 ROCKRIDGE CT APT 5, MISSOULA, MT 59808-9048
(605) 661-0879
Mailing address
2803 ROCKRIDGE CT APT 5, MISSOULA, MT 59808-9048
(605) 661-0879

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1544
SD
225100000X
Physical Therapist
Primary
2157
MT
225100000X
Physical Therapist
2759
ID

Other

Enumeration date
08/25/2011
Last updated
08/25/2011
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