Wild Crea, Mary Theresa

Wild Crea, Mary Theresa is an individual health care provider with primary practice located at 5975 Carmen Ave , Inver Grove Heights MN 55076-4416. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Wild Crea, Mary Theresa can be contacted via phone (651) 455-9697.

Contact Information

Primary practice address
5975 Carmen Ave Inver Grove Heights MN 55076-4416
Phone: (651) 455-9697
Fax: (651) 455-2012
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 38767 Minnesota

Profile Details

NPI number 1982604096
LBN Legal business name Wild Crea, Mary Theresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Jul 8th, 2007 - about 18 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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