Individual
DAVID CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20603
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051668
UNITED HEALTHCARE/OPTUM
MA
05
—
110101073A
—
MA
01
—
1269242
CIGNA/ASH
MA
01
—
4741862
AETNA
MA
Enumeration date
09/09/2013
Last updated
07/11/2018
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