Individual
MICHELLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
218 FAST ICE DR, MIDLAND, MI 48642-6167
(989) 631-2320
Mailing address
2900 E ELM RD, CLARE, MI 48617-9493
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4704280549
MI
163W00000X
Registered Nurse
Primary
4704280549
MI
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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