Clark, Patricia M

Clark, Patricia M is an individual health care provider with primary practice located at 121 Hospital Dr , Watertown WI 53098-3303. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Clark, Patricia M can be contacted via phone (920) 261-9220.

Contact Information

Primary practice address
121 Hospital Dr Watertown WI 53098-3303
Phone: (920) 261-9220
Fax: (920) 261-9208
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 2898-026 Wisconsin

Profile Details

NPI number 1568518561
LBN Legal business name Clark, Patricia M
Credentials Registered Occupational Therapist (OTR)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Jun 12th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568518561 NPPES
Wisconsin MEDICAID 40796800

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