Individual
CRYSTA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
240 MAPLE AVE, MUKWONAGO, WI 53149-8475
(262) 928-1715
(262) 363-1918
Mailing address
240 MAPLE AVE, MUKWONAGO, WI 53149-8475
(262) 928-1715
(262) 363-1918
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15117
WI
Other
Enumeration date
08/03/2020
Last updated
02/03/2026
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