Individual
CHERYL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA A4176
Contact information
Practice address
5721 GROSVENOR LN, BETHESDA, MD 20814-1833
(301) 530-1600
Mailing address
5 LAUER TER # 5, SILVER SPRING, MD 20901-4926
(301) 587-0959
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4176
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A4176
—
MD
Enumeration date
02/18/2019
Last updated
02/18/2019
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