Individual
ALYSE B CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
(309) 689-7094
Mailing address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
(309) 689-7094
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070020923
IL
Other
Enumeration date
08/29/2014
Last updated
12/31/2019
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