Individual
MR. JEFFREY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
18000 COVE STREET, SUITE 202, SPRING LAKE, MI 49456-1383
(616) 847-1280
(616) 847-1290
Mailing address
18000 COVE STREET, SUITE 202, SPRING LAKE, MI 49456-1383
(616) 847-1280
(616) 847-1290
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501015934
MI
Other
Enumeration date
09/28/2012
Last updated
07/01/2014
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