Clark, Crysta

Clark, Crysta is an individual health care provider with primary practice located at 10222 74Th St Ste 211 , Kenosha WI 53142-6810. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Clark, Crysta can be contacted via phone (262) 925-5020.

Contact Information

Primary practice address
10222 74Th St Ste 211 Kenosha WI 53142-6810
Phone: (262) 925-5020
Fax: (262) 925-5021
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 15117 Wisconsin

Profile Details

NPI number 1992315287
LBN Legal business name Clark, Crysta
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2020
Last updated Aug 3rd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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