Individual
CHRIS JAMES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
11178 KATRINE, TAYLOR, MI 48180
(734) 775-0052
Mailing address
11178 KATHERINE ST, TAYLOR, MI 48180-4287
(734) 775-0052
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501000298
MI
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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