Individual
JOHN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 N 56TH ST, 150, LINCOLN, NE 68504-3583
(402) 525-7467
Mailing address
111 N 56TH ST, 150, LINCOLN, NE 68504-3583
(402) 525-7467
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3017
NE
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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