Individual
DEBORAH JEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
8202 EXCELSIOR DR, MADISON, WI 53717-1906
(608) 662-5090
(608) 662-5091
Mailing address
8202 EXCELSIOR DR, MADISON, WI 53717-1906
(608) 662-5090
(608) 662-5091
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2969-146
WI
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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