Individual
KELLY LYNN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
124 HAWTHORNE LN, GREENWOOD, IN 46142-9430
(317) 332-9861
Mailing address
124 HAWTHORNE LN, GREENWOOD, IN 46142-9430
(317) 332-9861
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009306A
IN
Other
Enumeration date
08/08/2017
Last updated
07/21/2022
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