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General NPI Number Information
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NPI Number | 1295928810
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Entity Type | Individual
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Provider Name | RACHEL CLARK P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 123 GREY ST STE 5
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City | EAST AURORA
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State | NY
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Zip | 14052-2144
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Country | US
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Telephone | 716-671-7262
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Fax |
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Provider Business Mailing Address
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Address Line | 123 GREY ST STE 5
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City | EAST AURORA
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State | NY
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Zip | 14052-2144
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Country | US
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Telephone | 716-671-7262
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Fax | 716-671-6763
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 046904
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License Number State | NY
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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 | 29555
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License Number State | CA
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