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Individual

SHELBY LAYNE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
11100 HIGHWAY 165 STE 5, NORTH LITTLE ROCK, AR 72117-9781
(501) 945-0200
(501) 945-0245
Mailing address
PO BOX 5718, KALISPELL, MT 59903-5718
(406) 756-0134
(406) 309-2579

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1367761
TX
2251P0200X
Pediatric Physical Therapist
1367761
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1367761
TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS
TX
01
PT5170
ARKANSAS DEPARTMENT OF HEALTH STATE BOARD OF PHYSICAL THERAPY
AR
Enumeration date
08/25/2022
Last updated
02/09/2024
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