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Kimberly Carol Clark, BSCMT
Specialist in Portage, Michigan
NPI 1538593009

Kimberly Carol Clark is a Specialist based in Mattawan, MI. Kimberly Carol Clark practices in Portage, MI and has the professional credentials of BSCMT. The NPI Number for Kimberly Carol Clark is 1538593009 and holds a License No. (Michigan).

The current practice location address for Kimberly Carol Clark is 7901 S 12Th St, Portage, MI and can be reached out via phone at 269-720-6833. You can also correspond with Kimberly Carol Clark through the mailing address at 8874 PINE ISLAND CT S, MATTAWAN, MI - 49071-9570 (mailing address contact number: 269-720-6833).

Location: 7901 S 12Th St, Portage, MI, 49071-9570
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538593009
Provider Name
Kimberly Carol Clark
Credential
BSCMT
Provider Entity Type
Individual
Gender
Female
Address
7901 S 12Th St, Portage, MI, 49071-9570
Phone Number
269-720-6833
Fax Number
Provider Enumeration Date
09/02/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
225700000X 01 MI MASSAGE THERAPIST
institution
Provider Business Practice Location Address Details
Address
7901 S 12Th St
City
Portage
State
Michigan
Zip
49024-3831
Phone Number
269-720-6833
Fax Number
person
Provider Business Mailing Address Details
Address
7901 S 12Th St
City
Portage
State
Michigan
Zip
49024-3831
Phone Number
269-720-6833
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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