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General NPI Number Information
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NPI Number | 1053370254
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Entity Type | Individual
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Provider Name | ERICA CLARKSON DPT
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Gender | Female
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | CORNER OF ROUTE N12 AND N7
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City | FORT DEFIANCE
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State | AZ
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Zip | 86504-0649
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Country | US
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Telephone | 928-729-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 ROOKLIDGE ST
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City | DUPONT
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State | WA
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Zip | 98327-9745
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Country | US
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Telephone | 253-208-3735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1710I1003X
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Taxonomy Name | Independent Duty Medical Technicians
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License Number | 006851
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 006851
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License Number State | CT
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