Individual
VICKI MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-6050
Mailing address
4680 HUNTERS CIR W, CANTON, MI 48188-2377
(313) 920-8812
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
4704212789
MI
Other
Enumeration date
04/01/2014
Last updated
04/01/2014
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