Individual
STEPHANIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15227 SPRING COR, SAN ANTONIO, TX 78247-1693
(910) 922-1705
Mailing address
15227 SPRING COR, SAN ANTONIO, TX 78247-1693
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT132611
TX
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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