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General NPI Number Information
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NPI Number | 1861307746
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Entity Type | Individual
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Provider Name | ANTHONY CLARK PTA
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Gender | Male
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 58 WEAVER VILLAGE WAY #104
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City | WEAVERVILLE
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State | NC
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Zip | 28787
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Country | US
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Telephone | 828-348-7119
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Fax |
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Provider Business Mailing Address
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Address Line | 655 S WILLOW ST STE 128
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City | MANCHESTER
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State | NH
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Zip | 03103-5723
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Country | US
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Telephone | 800-995-2673
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | CP033348A
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | CP042973A
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | CP056309A
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA002758
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License Number State | WV
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Taxonomy #5
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | CP060501A
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License Number State | NC
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