Healthcare Provider Details

I. General information

NPI: 1669823373
Provider Name (Legal Business Name): ALLYSON R ROWLEY - CLARK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLYSON CLARK

II. Dates (important events)

Enumeration Date: 06/23/2016
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 PARADISE LN
SAXE VA
23967-5529
US

IV. Provider business mailing address

490 PARADISE LN
SAXE VA
23967-5529
US

V. Phone/Fax

Practice location:
  • Phone: 434-454-0629
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119006394
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: