Individual
MRS. LEATHA ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
86 COLUMBUS CIRCLE, STE 203, ATHENS, OH 45701-1331
(740) 249-4081
(740) 249-4126
Mailing address
PO BOX 742, ATHENS, OH 45701-0742
(740) 249-4081
(740) 249-4126
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
013398
OH
Other
Enumeration date
09/13/2011
Last updated
12/14/2011
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