Individual
DEBORAH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED PTA
Contact information
Practice address
4204 CRUMP RD, MEMPHIS, TN 38141-6907
(901) 921-5797
Mailing address
4204 CRUMP RD, MEMPHIS, TN 38141-6907
(901) 921-5797
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0000003386
TN
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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