Vandegraft, Clark O

Vandegraft, Clark O is an individual health care provider with primary practice located at 3614 N Rochelle Ln , Peoria IL 61604-1039. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Vandegraft, Clark O can be contacted via phone (309) 688-0350.

Contact Information

Primary practice address
3614 N Rochelle Ln Peoria IL 61604-1039
Phone: (309) 688-0350
Fax:
Website:
Map and Directions

Health care specialties

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

Profile Details

NPI number 1215493358
LBN Legal business name Vandegraft, Clark O
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2019
Last updated Feb 13th, 2019 - about 7 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.

Request for update

Popular Providers