Individual
MICHELE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
790 N HIGHWAY 67 ST, FLORISSANT, MO 63031-5108
(314) 972-1442
(314) 972-1533
Mailing address
790 N HIGHWAY 67 ST, FLORISSANT, MO 63031-5108
(314) 972-1442
(314) 972-1533
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2015027109
MO
Other
Enumeration date
06/25/2015
Last updated
12/30/2015
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