Individual
MS. INDIA D CLARK-BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
715 SUNNINGDALE DR, INKSTER, MI 48141-1240
(734) 716-3894
Mailing address
715 SUNNINGDALE DR, INKSTER, MI 48141-1240
(734) 716-3894
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703119508
MI
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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