Donna Clark, PT
Individual provider Active NPI Specialist · Clarks Summit, PA
NPI 1659675866 · NPPES record last updated Jan 3, 2011
Key facts
- NPI
- 1659675866
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- PT005703L (PA)
- Practice address
- 718 S State St
Clarks Summit, PA 18411-1749 - Phone
- (570) 586-2222
- Fax
- (570) 585-1321
- NPI assigned
- Jan 3, 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT005703L | PA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PT005703L | PA | Yes |
Addresses
Primary practice location
718 S State St
Clarks Summit, PA 18411-1749
Mailing address
718 S State St
Clarks Summit, PA 18411-1749
Phone (570) 586-2222
Other providers in Clarks Summit, PA
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- Catherine Chartorysky
- William Scott Chase II
- Ronnie Lee Chastain Jr.
- Clarks Summit Fire Company No 1 Inc
- CNB Therapy Counseling Services, LLC
- Jose Collado
- Dale W Collins
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All providers in Clarks Summit, PA · Specialist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2011. 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.