Individual
PETER MICHAEL CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
23 BRIDGTON RD, WESTBROOK, ME 04092-3653
(207) 797-3477
Mailing address
96 GRANDVIEW AVE, SOUTH PORTLAND, ME 04106-6114
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT226
ME
Other
Enumeration date
09/02/2005
Last updated
07/08/2007
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