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NPI Code Detail

MEDICARE: JENNIFER ANNETTE CLARK LMT

MEDICARE:   JENNIFER ANNETTE CLARK  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA51604FL

General Provider Information

NPI Number : 1831075597
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ANNETTE CLARK LMT
Provider Business Mailing Address
First Line : 525 NORTHLAKE BLVD
Second Line :
City : NORTH PALM BEACH
State : FL
Zip : 33408-5419
Country : US
Telephone Number : 561-844-1133
Fax Number :
Provider Business Practice Location Address
First Line : 525 NORTHLAKE BLVD STE 2
Second Line :
City : NORTH PALM BEACH
State : FL
Zip : 33408-5419
Country : US
Telephone Number : 561-844-1133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2025
Last Update Date : 08/15/2025

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Directions to “ JENNIFER ANNETTE CLARK LMT” Practice Location

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