Clark, Casey J.

Clark, Casey J. is an individual health care provider with primary practice located at 2170 S Lamar Blvd , Oxford MS 38655-5224. 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, Casey J. can be contacted via phone (662) 234-8559.

Contact Information

Primary practice address
2170 S Lamar Blvd Oxford MS 38655-5224
Phone: (662) 234-8559
Fax: (662) 234-7923
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT3203 Mississippi

Profile Details

NPI number 1174528871
LBN Legal business name Clark, Casey J.
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1174528871 NPPES
Mississippi MEDICAID 01802208

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