| NPI | 1790429074 |
|---|---|
| Other Name | TONY G CLARK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: PA MSG003643) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA-27231) |
| Enumeration Date | 2022-04-23 |
| Last Update Date | 2022-04-23 |