Individual
CLINTON SIMPLOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8953
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10407
TN
Other
Enumeration date
12/21/2015
Last updated
10/08/2024
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