Individual
JESSIE A LARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 3RD AVE S, ESCANABA, MI 49829-1237
(906) 786-5810
Mailing address
4251 L.5 ROAD, ESCANABA, MI 49829
(906) 280-1960
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007219
MI
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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