MR. Dallas Layne Clark, P.T.

NPI #1972693497 in Diamondville, Wyoming

Provider Information

NPI Number: 1972693497
Entity Type: Individual
Name: MR. Dallas Layne Clark, P.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: Oct 13, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 20 ADAVILLE DRIVE
Address 2: SUITE 10
City: Diamondville
State: Wyoming
ZIP Code: 83116
Phone: (307) 877-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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