Individual
DR. JON B CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
71 WALNUT BLVD, SUITE 109, ROCHESTER, MI 48307-2073
(248) 650-8990
(248) 650-8990
Mailing address
71 WALNUT BLVD, SUITE 109, ROCHESTER, MI 48307-2073
(248) 650-8990
(248) 650-8990
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301005160
MI
Other
Enumeration date
03/14/2006
Last updated
12/07/2016
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