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Individual

AUSTIN F CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
951 WATERBURY FALLS DR, O FALLON, MO 63368-2202
(636) 336-0300
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6200

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
12/20/2016
Last updated
12/20/2016
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