Individual
LANCE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4621 US HIGHWAY 59, GROVE, OK 74344-4237
(918) 786-3797
(918) 786-7395
Mailing address
4621 US HIGHWAY 59, GROVE, OK 74344-4237
(918) 786-3797
(918) 786-7395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3064
OK
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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