Individual
JUSTIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
14151 15 MILE RD, STERLING HEIGHTS, MI 48312-5507
(586) 939-0200
Mailing address
14151 15 MILE RD, STERLING HEIGHTS, MI 48312-5507
(586) 939-0200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008665
MI
Other
Enumeration date
03/26/2018
Last updated
06/12/2023
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