Individual
ALYSSA NANETTE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
140 N 4TH ST, EAST TOWER 17TH FLOOR, LOUISVILLE, KY 40202-4227
(502) 587-7644
Mailing address
1101 TALLOW LN, LOUISVILLE, KY 40214-5553
(812) 786-3169
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KY-4831
KY
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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