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Keisa Clark
NPI 1750921417 · on the registry since 2020
Practice
- Address
- 3119 Bradford Ct
Milford, MI 48380 - Phone
- (313) 647-1201
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-01-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan