Individual
REBECCA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4295 SERGEANT RD, SIOUX CITY, IA 51106-4625
(712) 560-0460
(712) 560-4137
Mailing address
4295 SERGEANT RD, SIOUX CITY, IA 51106-4625
(712) 560-0460
(712) 560-4137
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
096685
IA
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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