Individual
CANDY M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P. T.
Contact information
Practice address
781 E BRENHAM ST, GIDDINGS, TX 78942-2129
(979) 542-0223
(979) 542-1993
Mailing address
PO BOX 537, GIDDINGS, TX 78942-0537
(979) 542-0223
(979) 542-1993
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1040368
TX
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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