Juanita Clark

NPI #1306247762 in Sandusky, Michigan

Provider Information

NPI Number: 1306247762
Entity Type: Individual
Name: Juanita Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Sep 4, 2014
Last Updated: Sep 4, 2014

Practice Location

Address: 227 E SANILAC RD
City: Sandusky
State: Michigan
ZIP Code: 48471-1160
Phone: (810) 583-0432

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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