Individual
COLTON L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
825 LEONARD ST NE, GRAND RAPIDS, MI 49503-1177
(616) 200-4441
Mailing address
825 LEONARD ST NE, GRAND RAPIDS, MI 49503-1177
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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