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Individual

THREESE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
36 OLD OAK RD, PROSPECT, VA 23960-7925
(434) 391-9950
Mailing address
36 OLD OAK RD, PROSPECT, VA 23960-7925
(434) 391-9950

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003695
VA

Other

Enumeration date
04/09/2014
Last updated
04/09/2014
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