Individual
CAPRI N CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17083 US-6, SMETHPORT, PA 16749
(814) 887-5601
Mailing address
36 W 6TH ST, EMPORIUM, PA 15834-1202
(814) 594-1030
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP009858
PA
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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