Individual
JESSE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3485 WINDSOR AVE, DUBUQUE, IA 52001-1329
(563) 557-7180
Mailing address
418 COUNCIL ST, ANAMOSA, IA 52205-4711
(608) 778-5587
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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