Individual
MS. CRYSTAL LYNN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1500 MANLEY ST, DALTON HIGH SCHOOL, DALTON, GA 30720-4088
(734) 395-9716
Mailing address
1225 BROADRICK DR, DALTON, GA 30720-2504
(734) 395-9716
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002055
GA
Other
Enumeration date
08/31/2015
Last updated
08/31/2015
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