Individual
GREG CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2105 BRISTOL DR, JONESBORO, AR 72401-8505
(870) 405-9551
Mailing address
2105 BRISTOL DR, JONESBORO, AR 72401-8505
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
22783
FL
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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