Individual
DEONNA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
406 RIVERCHASE BLVD, MADISON, TN 37115-2034
(678) 431-8776
Mailing address
406 RIVERCHASE BLVD, MADISON, TN 37115-2034
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5482
TN
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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