Individual
ASHLEY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19132 IRVINGTON ST, DETROIT, MI 48203-1602
(313) 209-2861
Mailing address
19132 IRVINGTON ST, DETROIT, MI 48203-1602
(313) 209-2861
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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