Individual
AJANI SHAKIR CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5738 W ROOSEVELT DR, MILWAUKEE, WI 53216-3156
(414) 841-8295
Mailing address
5738 W ROOSEVELT DR, MILWAUKEE, WI 53216-3156
(414) 841-8295
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
C4620179245309
WI
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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