MR. Michael D Clark, PT

NPI #1982818811 in Wagoner, Oklahoma

Provider Information

NPI Number: 1982818811
Entity Type: Individual
Name: MR. Michael D Clark, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: May 9, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1200 W CHEROKEE ST
City: Wagoner
State: Oklahoma
ZIP Code: 74467-4624
Phone: (918) 485-1323

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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