Individual
EDWARD J CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
175 FRANKLIN ST, NORTH ADAMS, MA 01247-2712
(413) 664-4401
Mailing address
346 PLEASANT ST, DALTON, MA 01226-1137
(413) 684-0480
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2649
MA
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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