Individual
MISS THERESE MARIE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
278 DRY VALLEY RD, COOKEVILLE, TN 38506-5461
(931) 537-6524
Mailing address
1361 RILEY CREEK RD, WHITLEYVILLE, TN 38588-7024
(931) 268-1444
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0000003902
TN
Other
Enumeration date
08/11/2008
Last updated
08/11/2008
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