| NPI | 1306849955 |
|---|---|
| Professional Name | MIKE CLARK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00005772) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 2569) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2022-09-15 |