Clark, Dusty

Clark, Dusty is an individual health care provider with primary practice located at 5333 N Port Washington Rd Ste B , Glendale WI 53217-4914. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Clark, Dusty can be contacted via phone (414) 716-1770.

Contact Information

Primary practice address
5333 N Port Washington Rd Ste B Glendale WI 53217-4914
Phone: (414) 716-1770
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 1880-19 Wisconsin

Profile Details

NPI number 1306344163
LBN Legal business name Clark, Dusty
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2018
Last updated Jul 21st, 2021 - about 5 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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