Clark, Derek Dwight

Clark, Derek Dwight is an individual health care provider with primary practice located at 116 Market St , Mannington WV 26582-1131. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Clark, Derek Dwight can be contacted via phone (304) 986-1568.

Contact Information

Primary practice address
116 Market St Mannington WV 26582-1131
Phone: (304) 986-1568
Fax: (304) 986-1373
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2714 West Virginia

Profile Details

NPI number 1902059843
LBN Legal business name Clark, Derek Dwight
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2008
Last updated Sep 26th, 2012 - about 13 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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