Individual
MRS. JAMISON LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5820 HERITAGE LANDING DR, EAST SYRACUSE, NY 13057-9378
(315) 701-1107
Mailing address
3297 GREENLEAFE DR, PHOENIX, NY 13135-1538
(315) 941-2671
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
011737-1
NY
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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