Individual provider · Type 1 NPI

Tia Clark

Prosthetic/Orthotic Supplier · Philadelphia, PA

NPI number 1477478014 Active

Practice location

7131 N 20th St Fl 1
Philadelphia, PA 19138-2129

Specialties and licenses

Taxonomy	Code	License
Prosthetic/Orthotic Supplier Primary	335E00000X	CT176272 (PA)

Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

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About NPI 1477478014

Tia Clark's National Provider Identifier is 1477478014, issued on Aug 12, 2026. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Philadelphia, PA. The record was last updated on Aug 12, 2026.