Individual
KELSEY ANNE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8840 CYPRESS WATERS BLVD STE 300, COPPELL, TX 75019-4630
(469) 706-1045
Mailing address
9053 TRUMAN ST, SAN DIEGO, CA 92129-3629
(858) 349-9556
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4773
MD
Other
Enumeration date
08/18/2017
Last updated
08/18/2017
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