NPI | 1215325519 |
---|---|
Former Name | CARI FERN CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501018318) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1245607) |
Enumeration Date | 2015-01-08 |
Last Update Date | 2022-07-21 |