Jackie Clark

NPI #1124474457 in Parrish, Florida

Provider Information

NPI Number: 1124474457
Entity Type: Individual
Name: Jackie Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Enumeration Date: May 5, 2016
Last Updated: Dec 6, 2016

Practice Location

Address: 11472 WALDEN LOOP
City: Parrish
State: Florida
ZIP Code: 34219-7565
Phone: (941) 806-7555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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