Individual
EDWENA CHENELLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
200 MAYFIELD DR, SMYRNA, TN 37167-3019
(615) 355-0350
(615) 355-5549
Mailing address
200 MAYFIELD DR, SMYRNA, TN 37167-3019
(615) 355-0350
(615) 355-5549
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3098
TN
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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