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

Jae H Clark, ATC, LAT

Individual provider Athletic Trainer · NPI 1760247811

Jae H Clark, ATC, LAT is an Athletic Trainer in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2024.

Licensed in
PA
In the registry since
2024
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

1651 Benjamin Franklin Pkwy
Philadelphia, PA 19103-1284
Phone: (215) 303-4818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence RT005767 (PA)

Record details

NPI number1760247811
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC , LAT
Sole proprietorNo
NPI enumeratedFebruary 19, 2024
Last updated in NPPESFebruary 19, 2024
Certification dateFebruary 18, 2024

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