Individual
COLLEEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 CRESTWOOD PKWY NW STE 500, DULUTH, GA 30096-5585
(678) 924-5700
Mailing address
3700 CRESTWOOD PKWY NW STE 500, DULUTH, GA 30096-5585
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
04674
MD
Other
Enumeration date
09/16/2006
Last updated
12/09/2021
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