Individual
RACHEL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11800 XEON BLVD NW, COON RAPIDS, MN 55448-2061
(763) 755-8400
Mailing address
11800 XEON BLVD NW, COON RAPIDS, MN 55448-2061
(763) 755-8400
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
A2558
MN
225200000X
Physical Therapy Assistant
Primary
A2558
MN
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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