NPI 1043554256

Amanda J Clark, PT

Practitioner Physical Therapist Bloomington, IN

Practice location

Address: 1312 W Arch Haven Ave Bldg 1320 Suite E, Bloomington, IN 47403-2089
Phone: (812) 336-8406
Fax: (812) 336-8342
Mailing address: 790 Remington Blvd, Bolingbrook, IL 60440-4909

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 05007177A (IN)

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Registry record

NPI: 1043554256
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Nov 2012
Record last updated: 16 Feb 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.