Individual
AMY ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
650 W HEMLOCK ST, SEQUIM, WA 98382-3718
(785) 392-7117
Mailing address
PO BOX 96, BARNARD, KS 67418-0096
(785) 392-7117
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60176395
WA
Other
Enumeration date
02/14/2011
Last updated
02/14/2011
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