Individual
GWENDOLYN CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
590 S MAGNOLIA AVE, EL CAJON, CA 92020-6011
(619) 444-6113
Mailing address
6780 FRIARS RD UNIT 117, SAN DIEGO, CA 92108-1184
(720) 244-0210
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50045
CA
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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