Individual
CLARK HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
215 HIGHLAND CIRCLE DR, PORTLAND, TN 37148-4918
(615) 325-9263
Mailing address
215 HIGHLAND CIRCLE DR, PORTLAND, TN 37148-4918
(615) 325-9263
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3596
TN
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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