JASON CLARK

DETROIT, MI
NPI1821215047
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MI  4704237361)
Enumeration Date2007-04-19
Last Update Date2007-07-08
Business Address
-- JASON CLARK CRNA
3990 JOHN R ST
DETROIT, MI 48201-2018
Phone number: 952-442-9770
Mailing Address
-- JASON CLARK CRNA
PO BOX 67000 DEPT 203401
DETROIT, MI 48267-2034
Phone number: 952-442-9770
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