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

Russell Derrick Clark, DPT

Individual provider Physical Therapist · NPI 1639530686

Russell Derrick Clark, DPT is a Physical Therapist in Greenville, South Carolina. Licensed in South Carolina. Registered with an NPI since 2016.

Licensed in
SC
In the registry since
2016
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1011 Grove Rd Ste 2A
Greenville, SC 29605-4660
Phone: (864) 233-5128
Fax: (864) 271-2599
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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 8087 (SC)

Record details

NPI number1639530686
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedMarch 17, 2016
Last updated in NPPESMarch 17, 2016

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