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1053417907
KELLY L CLARK
CONWAY, AR
NPI
1053417907
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Former Name
KELLY L WOOD
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: AR 2010)
Enumeration Date
2006-09-16
Last Update Date
2007-07-08
Business Address
Mrs. KELLY L CLARK PTA
1500 MUSEUM RD STE 104
CONWAY, AR 72032-4761
Phone number: 501-329-3804
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Mailing Address
Mrs. KELLY L CLARK PTA
1500 MUSEUM RD STE 104
CONWAY, AR 72032-4761
Phone number: 501-329-3804
Copy
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