Individual
ALYCIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1252 BROADWAY STE B, PLACERVILLE, CA 95667-5827
(530) 622-9410
Mailing address
1252 BROADWAY STE B, PLACERVILLE, CA 95667-5827
(530) 622-9410
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
294102
CA
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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