NPI 1033535620

Thalaline Mayer Clack, PTDPT

Practitioner Physical Therapist Monroe, GA

Practice location

Address: 920 Georgia Highway 138, Monroe, GA 30655-0793
Phone: (812) 345-2685
Mailing address: 2180 Breezewood Drive, Monroe, GA 30014-0793

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 10022 (GA)

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Registry record

NPI: 1033535620
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Mar 2014
Record last updated: 6 Apr 2015

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.