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1457498214
MAYA CLARK
DETROIT, MI
NPI
1457498214
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704173166)
Enumeration Date
2007-01-31
Last Update Date
2007-07-08
Business Address
-- MAYA CLARK NP
13400 W OUTER DR
DETROIT, MI 48239-1309
Phone number: 313-592-5216
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Mailing Address
-- MAYA CLARK NP
13924 BURNING TREE LN
PLYMOUTH, MI 48170-2699
Phone number: 734-667-5282
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