Individual
CHRISTIE M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
503 N MAPLE ST, EFFINGHAM, IL 62401
(217) 347-1243
(217) 347-1558
Mailing address
503 N MAPLE ST, EFFINGHAM, IL 62401
(217) 347-1243
(217) 347-1558
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056004595
IL
Other
Enumeration date
04/28/2010
Last updated
07/23/2012
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