NPI 1013233477

Timothy Albert Clark, LMT

Practitioner Massage Therapist Louisville, KY

Practice location

Address: 2010 Bonnycastle Ave APT 1f, Louisville, KY 40205-1118
Phone: (502) 459-1557

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence KY-2716 (KY)

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Registry record

NPI: 1013233477
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Apr 2010
Record last updated: 10 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.