Crystal Nichols Clark, LPTA

NPI #1104155480 in Rustburg, Virginia

Provider Information

NPI Number
1104155480
Entity Type
Individual
Name
Crystal Nichols Clark, LPTA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physical Therapy Assistant
Credential
LPTA
Enumeration Date
Dec 15, 2009
Last Updated
Dec 15, 2009

Practice Location

Address
4968 BETHANY RD
ZIP Code
24588-3693
Phone
(434) 845-3554

Specialties & Taxonomy Codes

Specialty
Physical Therapy Assistant

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