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1013135797
KELLY JO CLARK
CHICAGO, IL
NPI
1013135797
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070012560)
Enumeration Date
2007-04-20
Last Update Date
2008-12-02
Business Address
KELLY JO CLARK PT
1527 N WELLS ST
CHICAGO, IL 60610-1307
Phone number: 312-642-8114
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Mailing Address
KELLY JO CLARK PT
205 W WACKER DR SUITE 1020
CHICAGO, IL 60606-1216
Phone number: 312-640-0329
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