NPI | 1548893308 |
---|---|
Former Name | DOROTHY KATHLEN CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT4551) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2020-02-19 |
Last Update Date | 2024-12-18 |