Individual ProviderMary Lynn ClarkPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address85 Barnes Rd, Suite 109, Wallingford, CT 06492-1832(203) 697-1067(860) 409-4595PECOS EnrollmentBased on the most recent information from CMS, provider Mary Lynn Clark does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1225174295Provider TypeIndividualFull NameClark, Mary LynnTitleMs.CredentialPTGenderFemaleSole ProprietorNoEnumeration Date1/29/2007Last Updated8/23/2016Contact InformationPractice LocationPractice Address85 Barnes Rd, Suite 109, Wallingford, CT 06492-1832Phone(203) 697-1067Fax(203) 284-0492Mailing LocationMailing Address47 N Main St, Suite 109, West Hartford, CT 06107-1926Phone(860) 409-4595Fax(860) 409-4860Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense002882Connecticut