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Individual

MR. JAMES MARION CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
2318 SUNSET BLVD, WEST COLUMBIA, SC 29169-4716
(803) 454-6090
Mailing address
1053 CENTER ST, WEST COLUMBIA, SC 29169-6749

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1633
SC

Other

Enumeration date
01/16/2009
Last updated
01/16/2009
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