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1679943328
JONATHAN WILSON CLARK
BAKER CITY, OR
NPI
1679943328
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: OR 342831)
Enumeration Date
2015-10-06
Last Update Date
2015-10-06
Business Address
JONATHAN WILSON CLARK OTR/L
3175 POCAHONTAS RD
BAKER CITY, OR 97814-1434
Phone number: 541-523-4415
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Mailing Address
JONATHAN WILSON CLARK OTR/L
3510 8TH DR
BAKER CITY, OR 97814-1516
Phone number: 801-413-4395
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