Individual
JOHN CASEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
448 LEWIS HARGETT CIR, SUITE 100, LEXINGTON, KY 40503-3594
(859) 313-5250
Mailing address
2294 LYONS STATION RD, NEW HAVEN, KY 40051-8723
(859) 576-9382
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R4232
KY
Other
Enumeration date
02/04/2011
Last updated
03/07/2016
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