Individual
MARISOL PAIGE ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
7467 SAINT ANDREWS RD, SUITE 9, IRMO, SC 29063-2875
(803) 749-5031
(803) 749-5032
Mailing address
7467 SAINT ANDREWS RD, SUITE 9, IRMO, SC 29063-2875
(803) 749-5031
(803) 749-5032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7916
SC
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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