Individual
JORDAN MICHAEL CLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
725 BUTLER AVE, OSHKOSH, WI 54901-8149
(920) 237-6300
Mailing address
725 BUTLER AVE, OSHKOSH, WI 54901-8149
(920) 237-6300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5415
WI
Other
Enumeration date
01/02/2019
Last updated
01/02/2019
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