Individual
MRS. AMY SUE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT.DPT, CMT
Contact information
Practice address
4525 WEAVER PKWY, SUITE 310, WARRENVILLE, IL 60555-0318
(917) 428-0193
Mailing address
1515 VILLAGE DR., COTTAGE GROVE, OR 97424
(541) 767-5260
(541) 767-2566
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06952
OR
225100000X
Physical Therapist
1179646
TX
225100000X
Physical Therapist
1964
AK
225100000X
Physical Therapist
2305205786
VA
225100000X
Physical Therapist
62 028723
NY
225100000X
Physical Therapist
—
—
Other
Enumeration date
01/20/2009
Last updated
11/27/2013
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