Individual
ANDREW CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3337
(801) 357-7850
Mailing address
859 N 200 W, AMERICAN FORK, UT 84003-3720
(832) 202-7034
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
501248
UT
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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