Individual
COURTNEY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 N HURSTBOURNE PKWY, SUITE 200, LOUISVILLE, KY 40222-5185
(502) 412-5847
Mailing address
4100 N MORRISON RD, MUNCIE, IN 47304-6043
(765) 286-9066
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
99062618A
IN
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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