Individual
MATTHEW CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1721 SE 17TH ST APT 530, FORT LAUDERDALE, FL 33316-3145
(770) 280-5971
Mailing address
1721 SE 17TH ST APT 530, FORT LAUDERDALE, FL 33316-3145
(770) 280-5971
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA104094
FL
Other
Enumeration date
01/01/2024
Last updated
01/02/2024
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