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1083617906
CHAD ALAN CLARK
PUEBLO, CO
NPI
1083617906
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CO 5835)
Enumeration Date
2005-05-24
Last Update Date
2011-09-01
Business Address
Mr. CHAD ALAN CLARK MSPT
58 GLENROYAL DR
PUEBLO, CO 81005-2174
Phone number: 719-565-6678
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Mailing Address
Mr. CHAD ALAN CLARK MSPT
58 GLENROYAL DR
PUEBLO, CO 81005-2174
Phone number: 719-565-6678
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