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1821534439
CAMIEL CLARK
POCATELLO, ID
NPI
1821534439
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Former Name
CAMIEL LYNN EBERLINE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ID OT-1635)
Enumeration Date
2017-01-06
Last Update Date
2017-01-06
Business Address
-- CAMIEL CLARK OTR/L
1071 RENEE AVE
POCATELLO, ID 83201-2508
Phone number: 208-233-1411
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Mailing Address
-- CAMIEL CLARK OTR/L
1615 E CLARK ST
POCATELLO, ID 83201-4049
Phone number: 907-252-7295
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