Individual
TRACY LYNN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
27794 REEL RD, WARRENTON, MO 63383-1941
(314) 267-4364
Mailing address
27794 REEL RD, WARRENTON, MO 63383-1941
(314) 267-4364
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
117465
MO
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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