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KELLY CLARK LMT
NPI 1134966567
Massage Therapist in Ann Arbor, MI

Active since July 12, 2024
4488 JACKSON RD STE 2A, ANN ARBOR, MI 48103(734) 260-7235 Get Directions Write a Review

NPPES record last updated: July 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Clark Lmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY CLARK LMT (NPI 1134966567) is an individual massage therapist in Ann Arbor, Michigan, licensed in Michigan (7501007777) and active in the NPI registry since July 2024.

NPPES Registry Identity

NPI1134966567
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameKELLY CLARKCredential: LMT
Location Address4488 JACKSON RD STE 2AAnn Arbor, MI 48103-1812
Mailing Address509 Little Lake DrAnn Arbor, MI 48103-6224 · (734) 260-7235
Phone(734) 260-7235
Sole ProprietorYes
Enumeration DateJuly 12, 2024
NPPES CertifiedJuly 12, 2024
✔ NPI 1134966567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in MI · 7501007777
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
4488 JACKSON RD STE 2A, Ann Arbor, MI 48103
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1134966567. It was assigned to this individual provider in the NPPES registry on July 12, 2024.

Where is Kelly Clark located?

Kelly Clark practices at 4488 Jackson Rd Ste 2A, Ann Arbor, MI 48103. The listed phone number is (734) 260-7235.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on July 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.