Individual
BENJAMIN BRIAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7909 FORREST AVE, BELTON, MO 64012-5303
(816) 738-1666
Mailing address
7909 FORREST AVE, BELTON, MO 64012-5303
(816) 738-1666
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2014030338
MO
Other
Enumeration date
12/22/2014
Last updated
12/22/2014
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