Conie Clark
Physical Therapy Assistant in Clarence, MO. Individual provider (NPI-1).
NPI number1164098083
StatusActive
Last updated in NPPESJun 1, 2021
Details
- NPI
- 1164098083
- Entity type
- Individual (NPI-1)
- Name
- Conie Clark
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 1, 2021
- Certification date
- Jun 1, 2021
- Last updated
- Jun 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 2020021602 | MO | Yes |
Practice location
111 East StClarence, MO 63437-1902
Phone 660-699-2118
Mailing address
12864 Harvestor AveNew Cambria, MO 63558-3135
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physical Therapy Assistant providers in Clarence, MO
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.