Individual
LISA MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(812) 332-2265
Mailing address
1228 COLINBROOK CIR, GREENWOOD, IN 46143-3608
(513) 265-2845
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003278A
IN
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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