Individual
NINA CLARK LEX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 N FALL CREEK RD, WILSON, WY 83014
(970) 379-5503
Mailing address
PO BOX 1841, WILSON, WY 83014-1841
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT-1871
WY
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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