Crystal Nichols Clark, LPTA

Physical Therapy Assistant · Rustburg, VA

Individual Active NPI

NPI number 1104155480

Practice location

4968 Bethany Rd
Rustburg, VA 24588-3693
Phone
(434) 845-3554

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NPI record

NPI
1104155480
Entity type
Individual (Type 1)
Enumeration date
December 15, 2009
Last updated
December 15, 2009
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 2306001767 VA

About Crystal Clark

Crystal Nichols Clark, LPTA is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 4968 Bethany Rd, Rustburg, VA 24588-3693. The NPI number 1104155480 was assigned on December 15, 2009 and the record was last updated on December 15, 2009.

Crystal Clark lists a license in the registry: #2306001767 (VA) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Crystal Nichols Clark, LPTA?

The NPI number is 1104155480.

What is the phone number of Crystal Clark?

The phone number listed for the practice location is (434) 845-3554.

Where is Crystal Clark located?

4968 Bethany Rd, Rustburg, VA 24588-3693.

What is the taxonomy code for Crystal Clark?

The primary taxonomy code is 225200000X – Physical Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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