Individual
JACQUELINE MARIA CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT
Contact information
Practice address
660 GOLDEN RIDGE RD STE 130, GOLDEN, CO 80401-9541
(303) 275-2190
(720) 497-6767
Mailing address
660 GOLDEN RIDGE RD STE 130, GOLDEN, CO 80401-9541
(303) 275-2190
(720) 497-6767
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19799
CO
225100000X
Physical Therapist
40QA02002000
NJ
225100000X
Physical Therapist
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA02002000
NJ PT LICENSE
NJ
Enumeration date
04/15/2021
Last updated
07/15/2024
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