Individual
SHANNON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
860 W 132ND AVE, SPC 268, WESTMINSTER, CO 80234-1499
(720) 495-2942
Mailing address
860 W 132ND AVE, SPC 268, WESTMINSTER, CO 80234-1499
(720) 495-2942
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1072069
CO
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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