Individual
CONNIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, PT
Contact information
Practice address
2501 RANCH ROAD 620 S STE 140, LAKEWAY, TX 78734-6416
(512) 527-6944
(512) 572-7805
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
CP001210T
NH
225100000X
Physical Therapist
PTL.0015088
CO
225100000X
Physical Therapist
Primary
—
TX
Other
Enumeration date
06/05/2018
Last updated
12/21/2023
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