Individual provider · Type 1 NPI

Madison Mimi Clark

Rehabilitation Practitioner · Fullerton, CA

NPI number 1295478501 Active

Practice location

801 E. Chapman Ave #203
Fullerton, CA 92831-3839

Call (714) 680-9000 Map

Mailing address

PO Box 919
Fullerton, CA 92836-0919

Specialties and licenses

TaxonomyCodeLicense
Rehabilitation Practitioner Primary 225400000XNone listed

Rehabilitation Practitioner: A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

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About NPI 1295478501

Madison Mimi Clark's National Provider Identifier is 1295478501, issued on Apr 14, 2022. The primary taxonomy on file is Rehabilitation Practitioner (225400000X), and the practice location is in Fullerton, CA. The record was last updated on Apr 14, 2022.