Most Relevant Information
Provider Data
| NPI Number: | 1003196718 |
| Provider Name: | SHELLEY CLARK DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 2759 |
Most Important Dates
| Enumeration Date: | 08/25/2011 |
| Last Updated: | 08/25/2011 |
Provider Practice Location
2803 ROCKRIDGE CT APT 5
MISSOULA
MT
598089048
Practice Location Phone/Fax
| Phone: | 6056610879 |
| Fax: |
Provider Mailing Location
2803 ROCKRIDGE CT APT 5
MISSOULA
MT
598089048
Provider Mailing Phone/Fax
| Phone: | 6056610879 |
| Fax: |