Bonnie Kathleen Clark, PT, DPT
Individual provider Active NPI Physical Therapist · Danville, IN
NPI 1306134341 · NPPES record last updated Jan 17, 2018
Key facts
- NPI
- 1306134341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT010311 (GA)
- Practice address
- 197 E Broadway St
Danville, IN 46122-1803 - Phone
- (317) 318-5271
- NPI assigned
- Jul 12, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT010311 | GA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT010311 | GA | Yes |
Addresses
Primary practice location
197 E Broadway St
Danville, IN 46122-1803
Mailing address
197 E Broadway St
Danville, IN 46122-1803
Phone (317) 318-5271
Other providers in Danville, IN
- Jennifer S Caswell
- Center Civil Township Hendricks Cou
- Center for Sleep & Wake Disorders
- Jasmine Yukiko Chau
- Sumit Rishi Chawla
- Jane D Clark
- Teresa G Clark
- Anne Elizabeth Class
- Jonathon Scott Cline
- Olivia Grace Cody
All providers in Danville, IN · Physical Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.