Individual ProviderMarisol Paige Ann ClarkPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address7467 Saint Andrews Rd, Suite 9, Irmo, SC 29063-2875(803) 749-5031PECOS EnrollmentBased on the most recent information from CMS, provider Marisol Paige Ann 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 yesterday at 11:47 AM.Profile DetailsProvider ID1235508839Provider TypeIndividualFull NameClark, Marisol Paige AnnCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date9/24/2015Last Updated9/24/2015Contact InformationPractice LocationPractice Address7467 Saint Andrews Rd, Suite 9, Irmo, SC 29063-2875Phone(803) 749-5031Fax(803) 749-5032Mailing LocationMailing Address7467 Saint Andrews Rd, Suite 9, Irmo, SC 29063-2875Phone(803) 749-5031Fax(803) 749-5032Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense7916South Carolina