Individual
LAUREN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1840 WEALTHY ST SE, GRAND RAPIDS, MI 49506-2921
(517) 927-5861
Mailing address
8811 W GRAND RIVER HWY, GRAND LEDGE, MI 48837-9229
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13498
—
MI
Enumeration date
07/27/2021
Last updated
07/27/2021
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