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1154665446
TIMOTHY ROSS CLARK
TWIN FALLS, ID
NPI
1154665446
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: ID PTA168)
Enumeration Date
2012-11-27
Last Update Date
2012-11-27
Business Address
Mr. TIMOTHY ROSS CLARK PTA
201 10TH AVE N
TWIN FALLS, ID 83301-6372
Phone number: 208-734-4264
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Mailing Address
Mr. TIMOTHY ROSS CLARK PTA
201 10TH AVE N
TWIN FALLS, ID 83301-6372
Phone number:
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