Individual
MISS SHERRY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2395 WALL ST SE STE 176, CONYERS, GA 30013-6703
(770) 679-1553
(866) 666-4344
Mailing address
2395 WALL ST SE STE 176, CONYERS, GA 30013-6703
(770) 679-1553
(866) 666-4344
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PTA004524
GA
225200000X
Physical Therapy Assistant
Primary
PTA004524
GA
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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