IndividualActive
Kelly Clark
NPI 1053893073 · Physical Therapy Assistant · Weatherford, TX
Provider details
- NPI number
- 1053893073
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 2109081 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
970 Hilltop Dr
Weatherford, TX 76086-5488
Phone: (817) 808-1633
Approximate (ZIP-level) locationGet directions
Mailing address
3025 Yucca Rd
Willow Park, TX 76087-7116
Registry dates
- Enumerated
- 2018-09-06
- Last updated
- 2018-09-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.