Individual ProviderMallory KlonkOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address318 Columbus Ave, Sandusky, OH 44870(419) 366-0096PECOS EnrollmentBased on the most recent information from CMS, provider Mallory Klonk does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1740738160Provider TypeIndividualFull NameKlonk, MalloryGenderFemaleSole ProprietorNoEnumeration Date9/14/2016Last Updated9/14/2016Contact InformationPractice LocationPractice Address318 Columbus Ave, Sandusky, OH 44870Phone(419) 366-0096FaxUnlisted FaxMailing LocationMailing Address318 Columbus Ave, Sandusky, OH 44870Phone(419) 366-0096FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseOT008560Ohio