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1508150301
JASON CLARK
JOHNSON CITY, TN
NPI
1508150301
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: TN 4141)
Enumeration Date
2011-06-09
Last Update Date
2011-06-09
Business Address
-- JASON CLARK OTR/L
140 TECHNOLOGY LN
JOHNSON CITY, TN 37604-2004
Phone number: 423-979-0798
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Mailing Address
-- JASON CLARK OTR/L
420 WYNDHAM DR
GRAY, TN 37615-5229
Phone number: 352-359-6252
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