Individual
MRS. DEBRA MAE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1502 E CENTENNIAL DR, PITTSBURG, KS 66762-6718
(620) 235-0020
Mailing address
242 S 160TH ST, GIRARD, KS 66743-9487
(316) 250-4532
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-01411
KS
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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