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

Mr. Charles Kevin Clark, PT

Individual provider Physical Therapist · NPI 1093722902

Mr. Charles Kevin Clark, PT is a Physical Therapist in Phoenix, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

10214 N Tatum Blvd Ste B-500
Phoenix, AZ 85028-4224
Phone: (480) 264-6326
Fax: (480) 264-6328
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5471 (AZ)

Record details

NPI number1093722902
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedAugust 2, 2006
Last updated in NPPESSeptember 9, 2019

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