Individual
MRS. ELIZABETH LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
213 E MAIN ST, NEW BLOOMFIELD, PA 17068-9657
(717) 582-0054
Mailing address
3081 STONE ARCH RD, NEWPORT, PA 17074-8008
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP003489L
PA
Other
Enumeration date
02/02/2013
Last updated
02/02/2013
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