Individual
KRYSTLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
800 E MILHAM AVE, PORTAGE, MI 49002-1490
(269) 888-6813
Mailing address
1404 CAMBRIDGE DR, KALAMAZOO, MI 49001-4406
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1012724
MI
Other
Enumeration date
08/03/2021
Last updated
08/03/2021
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