Individual
CLYDE BURCHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1409 W MAIN ST, LAKE CITY, IA 51449-1578
(712) 464-7951
Mailing address
606 S 9TH ST, SAC CITY, IA 50583-2604
(870) 656-3488
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01651
IA
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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