Individual
MR. MICHAEL AHART CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2010 MOUNT ZION RD, C, MORROW, GA 30260-3314
(678) 610-7581
(678) 610-4047
Mailing address
118 AUDUBON PKWY, STOCKBRIDGE, GA 30281-1743
(678) 984-2943
(678) 272-6295
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT000829
GA
Other
Enumeration date
07/11/2010
Last updated
07/11/2010
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