Individual
VICTORIA DENE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24111 SOUTHFIELD RD, SOUTHFIELD, MI 48075-2841
(248) 557-8800
(248) 557-8860
Mailing address
30760 NELSON CIRCLE, WESTLAND, MI 48186
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704276153
MI
Other
Enumeration date
06/17/2014
Last updated
11/20/2014
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