Clark, Jonathan Daniel

Clark, Jonathan Daniel is an sole proprietor health care provider with primary practice located at 11306 County Line Rd , Madison AL 35756-2011. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Clark, Jonathan Daniel can be contacted via phone (256) 216-5313.

Contact Information

Primary practice address
11306 County Line Rd Madison AL 35756-2011
Phone: (256) 216-5313
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 1378 Alabama

Profile Details

NPI number 1932508165
LBN Legal business name Clark, Jonathan Daniel
Credentials MS, LAT, ATC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 13th, 2014
Last updated Aug 13th, 2014 - about 11 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 1932508165 NPPES
Other 2000006545 BOC CERTIFIED ATHLETIC TRAINER
Other 1378 BOC CERTIFIED ATHLETIC TRAINER

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