Individual
MARVIN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCHW
Contact information
Practice address
12841 E MCNICHOLS RD, DETROIT, MI 48205-3343
(313) 701-8314
Mailing address
11366 WHITEHILL ST, DETROIT, MI 48224-1653
(313) 701-8314
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
142899725
MI
Other
Enumeration date
05/22/2025
Last updated
06/25/2025
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