Individual
LISA RENEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7687 CORTLAND AVE, ALLEN PARK, MI 48101-2213
(313) 585-4492
Mailing address
7687 CORTLAND AVE, ALLEN PARK, MI 48101-2213
(313) 585-4492
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
—
—
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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