Clark, Leroy S.

Clark, Leroy S. is an individual health care provider with primary practice located at 3120 Highland Rd , Hermitage PA 16148-4512. 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, Leroy S. can be contacted via phone (724) 342-2663.

Contact Information

Primary practice address
3120 Highland Rd Hermitage PA 16148-4512
Phone: (724) 342-2663
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT007065L Pennsylvania

Profile Details

NPI number 1073518122
LBN Legal business name Clark, Leroy S.
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Nov 7th, 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 1073518122 NPPES
Pennsylvania MEDICAID 0018014270001

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