Individual
DANA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 PHILLIPS RD, TALLAHASSEE, FL 32308-5304
(850) 942-9868
Mailing address
22292 NE LEE FARM RD, BLOUNTSTOWN, FL 32424-9636
18506437638
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTAT27624
FL
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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