Individual
MRS. LAUREN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9801 FULTON ST E, ADA, MI 49301-8915
(616) 240-4936
(616) 240-4936
Mailing address
9801 FULTON ST E, ADA, MI 49301-8915
(616) 240-4936
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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