Edwena Chenelle Clark, PTA

NPI #1497316541 in Smyrna, Tennessee

Provider Information

NPI Number: 1497316541
Entity Type: Individual
Name: Edwena Chenelle Clark, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jun 27, 2019
Last Updated: Jun 27, 2019

Practice Location

Address: 200 MAYFIELD DR
City: Smyrna
State: Tennessee
ZIP Code: 37167-3019
Phone: (615) 355-0350

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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