Individual
SAMANTHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 HAZEN ST STE C, PAW PAW, MI 49079-2008
(269) 655-3334
Mailing address
PO BOX 249, PAW PAW, MI 49079-0249
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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