NPI 1053476929

Pamela R. Clack, PT

Practitioner Pediatric Physical Therapist Monroe, GA

Practice location

Address: 703 Kings Rdg, Monroe, GA 30655-2051
Phone: (770) 207-5788
Fax: (770) 207-5708
Mailing address: 1500 Launius Rd, Good Hope, GA 30641-2637

Registered specialties

Pediatric Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2251P0200X Licence 001415 (GA)

Other Physical Therapist providers in Georgia →

Registry record

NPI: 1053476929
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Dec 2006
Record last updated: 8 Jul 2007

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.