Individual
MS. MICHELLE LOUISE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
409 CEDAR ST, ROGUE RIVER, OR 97537-9524
(541) 299-0139
Mailing address
PO BOX 265, 409 CEDAR ST, ROGUE RIVER, OR 97537-0265
(541) 299-0139
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/15/2010
Last updated
01/15/2010
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