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Individual

DEREK DWIGHT CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
116 MARKET ST, MANNINGTON, WV 26582-1131
(304) 986-1568
(304) 986-1373
Mailing address
4 EASTGATE PLZ, MORGANTOWN, WV 26508-9544
(304) 225-0910
(304) 225-0949

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2714
WV

Other

Enumeration date
10/23/2008
Last updated
09/26/2012
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