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1639530686
RUSSELL DERRICK CLARK
GREENVILLE, SC
NPI
1639530686
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: SC 8087)
Enumeration Date
2016-03-17
Last Update Date
2016-03-17
Business Address
-- RUSSELL DERRICK CLARK DPT
1011 GROVE RD STE 2A
GREENVILLE, SC 29605-4660
Phone number: 864-233-5128
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Mailing Address
-- RUSSELL DERRICK CLARK DPT
1011 GROVE RD STE 2A
GREENVILLE, SC 29605-4660
Phone number: 864-233-5128
Copy
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