Individual
NANCY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1147 S BAY DR, TAWAS CITY, MI 48763-9318
(989) 284-7258
Mailing address
814 W BELLE AVE, SAINT CHARLES, MI 48655-1616
(989) 284-7258
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201003815
MI
Other
Enumeration date
05/25/2020
Last updated
05/25/2020
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