Carla Marie Clark, PTA

NPI #1982890414 in Port Hueneme, California

Provider Information

NPI Number: 1982890414
Entity Type: Individual
Name: Carla Marie Clark, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Sep 19, 2007
Last Updated: Sep 19, 2007

Practice Location

Address: 709 W CHANNEL ISLANDS BLVD
Address 2: SUITE 157
City: Port Hueneme
State: California
ZIP Code: 93041-2130
Phone: (805) 382-6245

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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