| NPI | 1558537043 |
|---|---|
| Former Name | DEBORAH JEAN CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05000816A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 2358) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-05 |