Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gavin Clark, PT

Individual provider Physical Therapist · NPI 1952271975

Gavin Clark, PT is a Physical Therapist in Private Practice in Dewitt, Michigan. Qualified in 2025, 1 year ago. Practices with Jdr74 Holdings, LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
1
Licensed in
MI
In the registry since
2025
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

See every abbreviation used in this directory →

Practice location Address checks out

13060 S US Highway 27 Ste C4
Dewitt, MI 48820-8619
Phone: (517) 668-6561
Fax: (517) 306-2372
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501303924 (MI)

Record details

NPI number1952271975
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedNovember 5, 2025
Last updated in NPPESNovember 5, 2025
Certification dateNovember 5, 2025
Mailing address13060 S Us Highway 27 Ste C4, Dewitt, MI 48820-8619

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Jdr74 Holdings, Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Dewitt