Clark, Michael

Clark, Michael is an individual health care provider with primary practice located at 341 Greeno Road , Fairhope AL 36532. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as his primary health care specialty. Clark, Michael can be contacted via phone (251) 928-2401.

Contact Information

Primary practice address
341 Greeno Road Fairhope AL 36532
Phone: (251) 928-2401
Fax: (251) 928-5099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X PTH2465 Alabama

Profile Details

NPI number 1336147289
LBN Legal business name Clark, Michael
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Feb 18th, 2009 - about 16 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 1336147289 NPPES
Alabama Other 051077610 BCBS
Alabama MEDICAID 890006680 BCBS

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