Individual provider · Type 1 NPI

Dusty Clark, PTA

Physical Therapy Assistant · Glendale, WI

NPI number 1306344163 Active

Practice location

5333 N Port Washington Rd Ste B
Glendale, WI 53217-4914

Call (414) 716-1770 Map

Mailing address

33900 Harper Ave Ste 104
Clinton Township, MI 48035-4258

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X1880-19 (WI)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1306344163

Dusty Clark, PTA's National Provider Identifier is 1306344163, issued on Jan 26, 2018. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Glendale, WI. The record was last updated on Jul 21, 2021.