Individual
HALEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
3525 HULL RD, LESLIE, MI 49251-9576
(517) 927-1065
Mailing address
3527 HULL RD, LESLIE, MI 49251-9576
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002359
MI
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/27/2016
Last updated
08/28/2020
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