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Individual

CARLA MARIE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
709 W CHANNEL ISLANDS BLVD, SUITE 157, PORT HUENEME, CA 93041-2130
(805) 382-6245
(805) 382-6245
Mailing address
709 W CHANNEL ISLANDS BLVD, SUITE 157, PORT HUENEME, CA 93041-2130
(805) 382-6245
(805) 382-6245

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 6660
CA

Other

Enumeration date
09/19/2007
Last updated
09/19/2007
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