Individual
MRS. MICHELLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4573 NORMANDIE PL, LA MESA, CA 91942-8502
(619) 884-4495
Mailing address
4573 NORMANDIE PL, LA MESA, CA 91942-8502
(619) 884-4495
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
—
—
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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