Individual
ANITA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2333 N BRENTWOOD CIR, LECANTO, FL 34461-8536
(352) 746-6600
Mailing address
4590 N CANYON TER, HERNANDO, FL 34442-3038
(352) 419-5122
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA18277
FL
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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