Individual
NICOLE GINETTE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT, PHD
Contact information
Practice address
1004 PROGRESS DR STE 100, LANSING, KS 66043-6323
(913) 351-3586
(913) 351-3939
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-06834
KS
225100000X
Physical Therapist
22938
MD
225100000X
Physical Therapist
PT22633
FL
Other
Enumeration date
04/26/2006
Last updated
07/08/2021
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