| Doctor Name: | DONALD LEE CLARK |
| NPI Number: | 1609991884 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT20159 |
| Business Practice Address: | 9908 Gulf Drive Anna Maria, FL - 34216 |
| Business Phone Number: | 9417788641 |
| Business Fax Number: | 9417792291 |
| Mailing Address: | Po Box 669, ANNA MARIA |
| State: | FL |
| Postal Code: | 342160669 |
| Phone Number: | 9417788641 |
| Fax Number: | 9417792291 |
| NPI Enumeration Date: | 03/20/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT20159 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |