Kimberly Carol Clark, B.S. CMT

NPI #1538593009 in Portage, Michigan

Provider Information

NPI Number: 1538593009
Entity Type: Individual
Name: Kimberly Carol Clark, B.S. CMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: B.S. CMT
Enumeration Date: Sep 2, 2013
Last Updated: Sep 4, 2013

Practice Location

Address: 7901 S 12TH ST
Address 2: SUITE 200
City: Portage
State: Michigan
ZIP Code: 49024-3831
Phone: (269) 720-6833

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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