Individual
CHRISTOPHER MATTHEW CLARK
Active
Individual
CHRISTOPHER MATTHEW CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
4704280192
MI
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
4704280192
MI
Other
Enumeration date
10/25/2011
Last updated
11/19/2018
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