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Individual

ADAM THOMAS CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT, OCS, COMT

Contact information

Practice address
2591 44TH ST SE STE 101, GRAND RAPIDS, MI 49512-9094
(616) 281-9237
(616) 281-3115
Mailing address
2591 44TH ST SE STE 101, GRAND RAPIDS, MI 49512-9094
(502) 489-5002
(616) 281-9237

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
007201
KY
2251X0800X
Orthopedic Physical Therapist
Primary
5501018297
MI

Other

Enumeration date
07/27/2017
Last updated
10/25/2022
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