KENNETH EUGENE CLARK

COLORADO SPRINGS, CO
NPI1063887834
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: CO  OTA.0000671)
Enumeration Date2015-12-04
Last Update Date2015-12-04
Business Address
-- KENNETH EUGENE CLARK COTA
4885 ELDON DR S
COLORADO SPRINGS, CO 80916-4431
Phone number: 253-486-3624
Mailing Address
-- KENNETH EUGENE CLARK COTA
4885 ELDON DR S
COLORADO SPRINGS, CO 80916-4431
Phone number: 253-486-3624
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