MR. Chad Alan Clark, MSPT

NPI #1083617906 in Pueblo, Colorado

Provider Information

NPI Number: 1083617906
Entity Type: Individual
Name: MR. Chad Alan Clark, MSPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MSPT
Enumeration Date: May 24, 2005
Last Updated: Sep 1, 2011

Practice Location

Address: 58 GLENROYAL DR
City: Pueblo
State: Colorado
ZIP Code: 81005-2174
Phone: (719) 565-6678

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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