Individual
MRS. LORA JOHNSON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2366 SPRINGER RD, LAWRENCEBURG, TN 38464-4459
(931) 766-6677
Mailing address
1136 AUSTIN CIR, LAWRENCEBURG, TN 38464-2900
(931) 762-9429
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000002621
TN
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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