| 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 |