Individual
ANDREA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
531 MADISON ST, ALBANY, CA 94706-1116
(510) 847-1496
Mailing address
531 MADISON ST, ALBANY, CA 94706-1116
(510) 847-1496
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19169
CA
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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