Provider Demographics
NPI:1508750043
Name:CLARK, ALISON REECE (DPT)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:REECE
Last Name:CLARK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 FOREST DR STE 145
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4211
Mailing Address - Country:US
Mailing Address - Phone:301-798-4838
Mailing Address - Fax:
Practice Address - Street 1:1750 FOREST DR STE 145
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4211
Practice Address - Country:US
Practice Address - Phone:301-798-4838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist