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1750756706
LATISHA CLARK
SAN ANTONIO, TX
NPI
1750756706
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX AT4794)
Enumeration Date
2015-12-02
Last Update Date
2015-12-02
Business Address
-- LATISHA CLARK MS, ATC, LAT
4301 BROADWAY ST
SAN ANTONIO, TX 78209-6318
Phone number: 210-829-3826
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Mailing Address
-- LATISHA CLARK MS, ATC, LAT
4301 BROADWAY ST
SAN ANTONIO, TX 78209-6318
Phone number:
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