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Clark Vandegraft, PTA
NPI 1215493358 · on the registry since 2019
Practice
- Address
- 3614 N Rochelle Ln
Peoria, IL 61604 - Phone
- (309) 688-0350
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 225200000X
225200000X
- Sex
- Male
- Record last updated
- 2019-02-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois