Individual
ZACHARY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
555 ANTHONY WAYNE TRL, WATERVILLE, OH 43566-1516
(419) 878-3901
Mailing address
555 ANTHONY WAYNE TRL, WATERVILLE, OH 43566-1516
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008680
OH
Other
Enumeration date
11/18/2016
Last updated
11/18/2016
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