Clark, Kenneth John
Clark, Kenneth John is an individual health care provider with primary practice located at 6619 1St Ave S , Saint Petersburg FL 33707-1305. 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, Kenneth John can be contacted via phone (417) 315-5577.Contact Information
Primary practice address
6619 1St Ave S
Saint Petersburg FL 33707-1305
Phone: (417) 315-5577
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT32691 | Florida |
Profile Details
| NPI number | 1144740580 |
|---|---|
| LBN Legal business name | Clark, Kenneth John |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2017 |
| Last updated | Feb 3rd, 2022 - about 4 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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