Individual
MRS. SUSAN KAY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, IBCLC
Contact information
Practice address
2621 W WACKERLY ST, SUITE D, MIDLAND, MI 48640-6993
(989) 832-8322
Mailing address
2621 W WACKERLY ST, SUITE D, MIDLAND, MI 48640-6993
(989) 832-8322
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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