Individual
KELLY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4488 JACKSON RD STE 2A, ANN ARBOR, MI 48103-1812
(734) 260-7235
Mailing address
509 LITTLE LAKE DR, ANN ARBOR, MI 48103-6224
(734) 260-7235
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501007777
MI
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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