Individual
MR. CHARLES CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
805 BLANKENBAKER PKWY, SUITE 107, LOUISVILLE, KY 40243-1894
(502) 253-0833
(502) 253-0834
Mailing address
800 CRESCENT CENTRE DR STE 600, FRANKLIN, TN 37067-7286
(615) 373-1350
(615) 221-9054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003320
KY
Other
Enumeration date
07/26/2006
Last updated
08/13/2019
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