Individual
SUZANNA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
4321 FIR ST, EAST CHICAGO, IN 46312-3097
(219) 392-7400
(219) 392-7408
Mailing address
2948 W 20TH PL, GARY, IN 46404-2660
(219) 793-4458
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008120A
IN
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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