Organization
ELITE PHYSICAL THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY RENEE CLARK RPT (PHYSICAL THERAPIST)
(918) 231-0735
Entity
Organization
Contact information
Practice address
2086 S MAIN ST, GROVE, OK 74344-5325
(918) 948-2758
Mailing address
713 LAKEWOOD DR, GROVE, OK 74344-5416
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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