Individual
DR. AUTUMN F CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT,PT
Contact information
Practice address
2182 DIXIE HWY, FT MITCHELL, KY 41017-2902
(859) 344-6001
Mailing address
2182 DIXIE HWY, FT MITCHELL, KY 41017-2902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006863
KY
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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