Individual
MRS. MELISSA GRAY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R. P. T.
Contact information
Practice address
1058 HOLLAND AVE, PHILADELPHIA, MS 39350-9121
(601) 650-9111
(601) 650-1972
Mailing address
10851 ROAD 327, UNION, MS 39365-7215
(601) 656-0075
(601) 650-1972
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0751
MS
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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