Individual
MRS. PAULA JEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.A.
Contact information
Practice address
308 E 3RD ST, LIBBY, MT 59923-2140
(406) 293-3032
Mailing address
PO BOX 608, BONNERS FERRY, ID 83805-0608
(209) 479-2754
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2700
MT
Other
Enumeration date
12/16/2013
Last updated
12/16/2013
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