Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DALLAS LAYNE CLARK, P.T.
ActiveMR. DALLAS LAYNE CLARK, P.T. is a Physical Therapy Assistant healthcare provider located in DIAMONDVILLE, Wyoming. NPI 1972693497 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · DIAMONDVILLE, WY
Registration Details
- NPI Number
- 1972693497
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 13, 2006 (19.790170886496 yrs)
- Last Updated
- Jul 9, 2007
- Licenses
-
6293691-2401 (UT)802 (WY)
Practice Information
- Address
-
20 ADAVILLE DRIVESUITE 10DIAMONDVILLE, WY, 83116Browse WY providers · Browse ZIP 83116
- Phone
- 3078771000
- Fax
- 3078771000
- Primary Specialty
-
Physical Therapy Assistant
225100000X
- Additional Specialty
- Physical Therapy Assistant
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.