Clark, Mary Martha

Clark, Mary Martha is an individual health care provider with primary practice located at 2495 Maplewood Drive Suite 313, Maplewood MN 55109-1913. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Clark, Mary Martha can be contacted via phone (651) 770-8884.

Contact Information

Primary practice address
2495 Maplewood Drive Suite 313 Maplewood MN 55109-1913
Phone: (651) 770-8884
Fax: (651) 770-8151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 100082 Minnesota

Profile Details

NPI number 1740325778
LBN Legal business name Clark, Mary Martha
Credentials OTR-L
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2007
Last updated Mar 25th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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