SearchPennsylvania2255A2300X

Jae Clark, ATC, LAT

NPI 1760247811 · on the registry since 2024

Practice

Address
1651 Benjamin Franklin Pkwy
Philadelphia, PA 19103
Phone
(215) 303-4818

Registry record

Primary taxonomy
2255A2300X
2255A2300X
Licence states on file
PA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-02-19

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 Pennsylvania