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DONALD LEE CLARK PT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1609991884

Individual Registrant:
 DONALD LEE CLARK PT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
9908 GULF DRIVE  ANNA MARIA, FL 34216 US
Tel: 941-778-8641  Fax: 941-779-2291

Contact information for business:
PO BOX 669  ANNA MARIA, FL 34216-0669 US
Tel: 941-778-8641  Fax: 941-779-2291

Registration Information:
NPI: 1609991884
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
FLPT20159

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
STATE LICENSEPT20159FL01




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