Individual
JOHN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 N WEST AVE, JACKSON, MI 49202-2179
(517) 789-1209
(517) 796-4532
Mailing address
1200 N WEST AVE, JACKSON, MI 49202-2179
(517) 789-1209
(517) 796-4532
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
MI
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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