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Individual

MRS. DARLENE KIM CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
108 3RD ST STE 26, ELKINS, WV 26241-3831
(304) 636-4070
(304) 636-4070
Mailing address
RR 1 BOX 170-2, BEVERLY, WV 26253-9748
(304) 636-8157

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
993
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7301118000
WV
Enumeration date
06/05/2008
Last updated
06/05/2008
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