Individual
SHARON L CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5537 SLEET DR, INDIANAPOLIS, IN 46237-2331
(317) 979-9026
Mailing address
5537 SLEET DR, INDIANAPOLIS, IN 46237-2331
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06000413A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06000413A
STATE LICENSE
IN
Enumeration date
04/23/2012
Last updated
04/23/2012
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