Individual
MRS. DEANNA JEAN CLARKE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
16 MENARD PLZ, WAUSAU, WI 54401-4119
(715) 845-2942
(715) 842-3416
Mailing address
6207 ISAIAH ST, WESTON, WI 54476-6606
(715) 298-1059
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
784019
WI
Other
Enumeration date
06/14/2006
Last updated
07/08/2007
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