| Doctor Name: | MR. GARY DUANE CLARK |
| NPI Number: | 1932159217 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT000497E |
| Business Practice Address: | 202 Union St Northwestern P.t. Services, Inc. Titusville, PA - 163541160 |
| Business Phone Number: | 8148272347 |
| Business Fax Number: | 8148272391 |
| Mailing Address: | 12 Jackson Way, TITUSVILLE |
| State: | PA |
| Postal Code: | 163542425 |
| Phone Number: | 8148272347 |
| Fax Number: | 8148272391 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT000497E |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| 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 |