Individual
KEVIN S CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, R.A.C.
Contact information
Practice address
312 MAIN ST, 2ND FLOOR, NORWICH, VT 05055-4418
(802) 649-5252
Mailing address
PO BOX 215, 312 MAIN STREET, NORWICH, VT 05055-0215
(802) 649-5252
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1685R
NH
Other
Enumeration date
11/17/2006
Last updated
11/24/2013
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