Individual
CELINA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
273 RIVERBANK ST, WYANDOTTE, MI 48192-2625
(734) 286-4140
Mailing address
273 RIVERBANK ST, WYANDOTTE, MI 48192-2625
(734) 286-4140
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502004777
MI
Other
Enumeration date
12/11/2015
Last updated
12/11/2015
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