Individual
MRS. NANCY ELLEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBA, OT/L
Contact information
Practice address
3080 HECLA ST, BUTTE, MT 59701-6320
(406) 491-4157
Mailing address
3080 HECLA ST, BUTTE, MT 59701-6320
(406) 491-4157
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
297
MT
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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