Individual
MICHAEL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.AC.
Contact information
Practice address
420 N CENTER ST, NORTHVILLE, MI 48167-1224
(248) 636-2156
Mailing address
420 N CENTER ST, NORTHVILLE, MI 48167-1224
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
5401000053
MI
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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