CLARK DRIVER

FT WORTH, TX
NPI1508263732
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence: TX  1673)
Additional Taxonomies222Z00000X Orthotist
(Licence: TX  1673)
Enumeration Date2014-12-03
Last Update Date2014-12-03
Business Address
-- CLARK DRIVER
1401 W MAGNOLIA AVE
FT WORTH, TX 76104-4250
Phone number: 817-923-2101
Mailing Address
-- CLARK DRIVER
1401 W MAGNOLIA AVE
FT WORTH, TX 76104-4250
Phone number: 817-923-2101