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1093019473
SHELEAH CLARK
FORT WAYNE, IN
NPI
1093019473
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32001852A)
Enumeration Date
2010-12-29
Last Update Date
2010-12-29
Business Address
Miss SHELEAH CLARK
3108 CANTERBURY BLVD APT 6
FORT WAYNE, IN 46835-3228
Phone number: 260-418-5419
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Mailing Address
Miss SHELEAH CLARK
3108 CANTERBURY BLVD APT 6
FORT WAYNE, IN 46835-3228
Phone number: 260-418-5419
Copy
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