Clarke, Susan Legender

Clarke, Susan Legender is an sole proprietor health care provider with primary practice located at 846 Laurel Ave , Saint Paul MN 55104-7110. She recently has only one registered license in Chiropractic Providers / Nutrition, which is considered as her primary health care specialty. Clarke, Susan Legender can be contacted via phone (651) 227-8776.

Contact Information

Primary practice address
846 Laurel Ave Saint Paul MN 55104-7110
Fax: (651) 227-1055
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Nutrition 111NN1001X 2143 Minnesota

Profile Details

NPI number 1013905371
LBN Legal business name Clarke, Susan Legender
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2005
Last updated Jun 16th, 2010 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1013905371 NPPES
Minnesota Other 350056171 RRCARE
Minnesota Other 041101001 RRCARE
Minnesota Other 21316CL RRCARE
Minnesota Other 0N438CL RRCARE
Minnesota MEDICAID 777027800 RRCARE
Minnesota Other 20705 RRCARE

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