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Individual

CHANCZLOR CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
15205 N DALE MABRY HWY, TAMPA, FL 33618-1810
(813) 605-4838
Mailing address
3500 NW 23RD CT, LAUDERDALE LAKES, FL 33311-2662
(754) 214-0423

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
FL

Other

Enumeration date
01/30/2026
Last updated
01/30/2026
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