Kelly Jo Clark, PT

NPI #1013135797 in Chicago, Illinois

Provider Information

NPI Number: 1013135797
Entity Type: Individual
Name: Kelly Jo Clark, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Apr 20, 2007
Last Updated: Dec 2, 2008

Practice Location

Address: 1527 N WELLS ST
City: Chicago
State: Illinois
ZIP Code: 60610-1307
Phone: (312) 642-8114

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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