Individual
LORNA CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5416 MERIDIAN RD, HASLETT, MI 48840-9724
(517) 580-7325
Mailing address
5416 MERIDIAN RD, HASLETT, MI 48840-9724
(517) 580-7325
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0170277
—
MI
Enumeration date
06/22/2015
Last updated
06/22/2015
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