Individual
PAUL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1800 BLUEGRASS AVE, LOUISVILLE, KY 40215-1130
(502) 361-2301
Mailing address
1800 BLUEGRASS AVE, LOUISVILLE, KY 40215-1130
(502) 375-6643
(502) 375-6632
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006176
KY
Other
Enumeration date
07/10/2014
Last updated
09/02/2015
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