Individual
JANNA KAY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
7130 ESTERO BLVD, FORT MYERS BEACH, FL 33931-4715
(917) 750-5793
Mailing address
5615 LEWIS ST, FORT MYERS BEACH, FL 33931-4127
(191) 775-0579
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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