Individual
MELISSA BETH CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
65 DUTCH LN, COLUMBUS, MS 39702-5523
(662) 241-4545
(662) 241-4025
Mailing address
23 COBBLE STONE DR, CALEDONIA, MS 39740-5501
(662) 241-4545
(662) 241-4025
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3370
MS
Other
Enumeration date
08/22/2005
Last updated
07/08/2007
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