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1023884731
ANDREW CLARK
PROVO, UT
NPI
1023884731
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: UT 501248)
Enumeration Date
2023-12-04
Last Update Date
2023-12-04
Business Address
ANDREW CLARK OTR/L
1034 N 500 W
PROVO, UT 84604-3337
Phone number: 801-357-7850
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Mailing Address
ANDREW CLARK OTR/L
859 N 200 W
AMERICAN FORK, UT 84003-3720
Phone number: 832-202-7034
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