Individual
CLARK HUSTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
873 BEAVER DR, DU BOIS, PA 15801-2511
(814) 503-8361
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 541-5490
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006654L
PA
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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