Provider Demographics
NPI:1487088407
Name:CLARKE, KERRI (MA)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BAYBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:MILLIS
Mailing Address - State:MA
Mailing Address - Zip Code:02054-1607
Mailing Address - Country:US
Mailing Address - Phone:781-910-9772
Mailing Address - Fax:
Practice Address - Street 1:16 BAYBERRY CIR
Practice Address - Street 2:
Practice Address - City:MILLIS
Practice Address - State:MA
Practice Address - Zip Code:02054-1607
Practice Address - Country:US
Practice Address - Phone:781-910-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist