Individual
ISABEAU CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10000 W 75TH ST STE 250, MERRIAM, KS 66204-2218
(888) 913-1910
Mailing address
1065 TUCKDA WAY, HAMPTONVILLE, NC 27020-8291
(888) 913-1910
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A6586
NC
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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