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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KELLY ANN CLARK, DPT, PT, MT

Active Sole Proprietor

DR. KELLY ANN CLARK, DPT, PT, MT is a Physical Therapy Assistant healthcare provider located in BLOOMINGTON, Indiana. NPI 1528614153 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · BLOOMINGTON, IN

Registration Details

NPI Number
1528614153
Provider Type
Individual
Gender
Female
NPI Issued
Aug 9, 2019 (6.8263076777308 yrs)
Last Updated
Aug 9, 2019
Licenses
MT21304740 (IN)
05013530A (IN)
Sole Proprietor
Yes

Practice Information

Address
2620 N WALNUT ST
SUITE 600
BLOOMINGTON, IN, 474042008
Browse IN providers · Browse ZIP 47404
Phone
8125580708
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in BLOOMINGTON, IN

Name Credential NPI
JASON R VANDEVENTER MPT 1205831070
JEFFREY D HEADDY RPT 1689679474
SANDRA RAY PT 1194722488
RENAE DAWN CARTWRIGHT PT 1467447672
THOMAS KELZER MS.ATC/PT 1497736565
MS. WENDELINE K. POPPY PT, LAT, ATC 1063494011
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.