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Individual

DELANE F CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
328 WHIPPOORWILL LN, MT HOLLY, NC 28120-9765
(704) 827-3788
(704) 827-3799
Mailing address
841 BETH HAVEN CHURCH RD, DENVER, NC 28037-8124
(704) 736-0996
(704) 736-0996

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2756
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7212080
NC
Enumeration date
08/08/2006
Last updated
04/10/2012
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