Individual
ROBERTA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
233 FLORIDA AVE, CAROLINA BEACH, NC 28428-5804
(910) 458-5859
Mailing address
233 FLORIDA AVE, CAROLINA BEACH, NC 28428-5804
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
223
NC
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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