Individual
DR. JESSICA LEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1030 SCOTT DR, PRESCOTT, AZ 86301-4737
(928) 778-2450
(928) 777-8840
Mailing address
1030 SCOTT DR, PRESCOTT, AZ 86301-4737
(607) 316-9863
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008971
AZ
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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