Individual
MARK ANTHONY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
727 SE MAIN ST, STE 200, SIMPSONVILLE, SC 29681-3247
(864) 454-6670
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4448
SC
2251P0200X
Pediatric Physical Therapist
4448
SC
Other
Enumeration date
06/30/2008
Last updated
11/05/2015
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