Organization
SUSAN K CLARK
Active
Other names
Lactation Mangement Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KAY CLARK MS, RD, IBCLC (OWNER)
(989) 832-8322
Entity
Organization
Contact information
Practice address
310 SEMINOLE COURT, MIDLAND, MI 48642-3572
(989) 832-8322
Mailing address
310 SEMINOLE COURT, MIDLAND, MI 48642-3572
(989) 832-8322
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4668053
—
MI
Enumeration date
08/02/2006
Last updated
09/11/2012
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