Individual
EDITH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
125 DWYER ST, CLARE, MI 48617-1002
(989) 386-9721
Mailing address
4310 LEONARD ST NW, SUITE 103, WALKER, MI 49534-8447
(616) 453-6329
(616) 453-1725
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
EC001742
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4613888
—
MI
Enumeration date
02/23/2006
Last updated
06/10/2010
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