Individual
BETHANY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
9 PINE CONE DR STE 104B, PALM COAST, FL 32137-8683
(386) 446-9716
Mailing address
108 CAMDEN CAY DR, ST AUGUSTINE, FL 32086-1814
(440) 864-5565
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT28112
FL
Other
Enumeration date
02/13/2013
Last updated
04/29/2019
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