Individual
MICHELLE B CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17809 PIERCE PLZ, OMAHA, NE 68130-1035
(402) 955-8355
(402) 955-8356
Mailing address
8200 DODGE ST, OMAHA, NE 68114-4113
(402) 955-5400
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
3652
NE
Other
Enumeration date
03/05/2018
Last updated
03/05/2018
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