Individual
CLARKE B ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
11225 N 28TH DR # SRF100, PHOENIX, AZ 85029-5606
(602) 866-0066
(602) 866-3868
Mailing address
15410 S MOUNTAIN PKWY, PHOENIX, AZ 85044-6691
(480) 706-1161
(480) 706-7997
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
31402
AZ
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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