Doctor Name: | MR. CHAMP MICHAEL CLARK |
NPI Number: | 1447531009 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T, PT, CSCS |
License Number: | 1208709 |
Business Practice Address: | 17350 St Lukes Way Suite 100 The Woodlands, TX - 773844100 |
Business Phone Number: | 9363210333 |
Business Fax Number: | |
Mailing Address: | 8 S Cypress Pine Dr, SPRING |
State: | TX |
Postal Code: | 773812811 |
Phone Number: | 7138199350 |
Fax Number: | |
NPI Enumeration Date: | 09/08/2011 |
NPI Last Update Date: | 09/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1208709 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |