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JONATHAN CLARK

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1841696820

Individual Registrant:
 JONATHAN  CLARK 
Gender: M
Sole Proprietor

Location and contact information for practice:
14049 SCENIC HWY  LOOKOUT MOUNTAIN, GA 30750-4100 US
Tel: 706-419-1523  Fax: --

Contact information for business:
922 FEDERAL ST  CHATTANOOGA, TN 37405-2931 US
Tel: --  Fax: --

Registration Information:
NPI: 1841696820
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
GAAT001654
N2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
TNAT0000001292

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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