Individual
CHARITY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4825 EMERALD ST, NORTON SHORES, MI 49441-5685
(231) 215-0691
Mailing address
4825 EMERALD ST, NORTON SHORES, MI 49441-5685
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502000181
MI
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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