Individual
JUANITA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
227 E SANILAC RD, SANDUSKY, MI 48471-1160
(810) 583-0432
(810) 648-5107
Mailing address
227 E SANILAC RD, SANDUSKY, MI 48471-1160
(810) 583-0432
(810) 648-5107
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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