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Individual

ALLYSSA-ASHLEY MARIE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
13620 METROPOLIS AVE STE 100, FORT MYERS, FL 33912-3406
(239) 220-2128
Mailing address
626 SE 13TH CT APT 1, CAPE CORAL, FL 33990-2616
(239) 220-2128

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA80966
FL

Other

Enumeration date
02/21/2022
Last updated
02/21/2022
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