Organization
CLARK PHYSICAL THERAPY & BODYWORK, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANNE CLARK PT (OWNER)
(802) 349-1808
Entity
Organization
Contact information
Practice address
614 MONKTON RD, BRISTOL, VT 05443-5392
(802) 349-1808
(802) 453-2988
Mailing address
621 SPLIT ROCK RD, NEW HAVEN, VT 05472-2106
(802) 877-9929
(802) 453-2988
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6702477
—
VT
Enumeration date
01/21/2020
Last updated
01/21/2020
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