Individual provider · NPI-1

Sabrina K Clark, ATC

Specialist/Technologist, Athletic Trainer · Jackson, TN

NPI number1972635993
StatusActive
Last updated in NPPESApr 20, 2009

Details

NPI
1972635993
Entity type
Individual (NPI-1)
Name
Mrs. Sabrina K Clark
Credential
ATC
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 12, 2007
Last updated
Apr 20, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic TrainerAT0000000766TNYes

Practice location

569 Skyline Dr
Suite 100
Jackson, TN 38301-3911

Phone 731-676-3739 · Fax 731-286-4259

Mailing address

1216 S Main St
Dyer, TN 38330-2214

Phone 731-676-3739

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