Individual
PETER JAMES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, AT-L, CSCS, MA
Contact information
Practice address
502 E BOONE AVE, AD BOX 66, SPOKANE, WA 99258-1774
(509) 313-5591
(509) 313-5789
Mailing address
502 E BOONE AVE, AD BOX 66, SPOKANE, WA 99258-1774
(509) 313-5591
(509) 313-5789
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160047423
WA
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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