Individual
CHARLES CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1900 OGDEN AVE, AURORA, IL 60504-4273
(630) 978-6218
(630) 978-6219
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-008359
IL
Other
Enumeration date
09/26/2005
Last updated
12/07/2016
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