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1861128605
AUSTIN J CLARK
GRAND RAPIDS, MI
NPI
1861128605
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601011296)
Enumeration Date
2022-07-25
Last Update Date
2022-11-14
Business Address
AUSTIN J CLARK PA
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503-2560
Phone number: 616-885-5000
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Mailing Address
AUSTIN J CLARK PA
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number: 616-486-6790
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