Individual
KELSEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
805 SUNSET BLVD, CONRAD, MT 59425-1717
(406) 271-3211
Mailing address
723 1ST AVE NW, CONRAD, MT 59425-1725
(406) 799-0223
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4442
MT
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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