Abigail Mae Clark PA-C

NPI 1740528611 - Physician Assistant - 363A00000X

NPI Details
NPI 1740528611
Gender Female
Enumeration Date 01/28/2013
Last Updated 07/01/2015
Entity Type Individual
Active Over 3 years ago
Practice Location
2090 WOODWINDS DR
WOODBURY MN, 55125-2522, US
Phone (651) 968-5801
Fax (651) 968-5899
Business Location
710 COMMERCE DR STE 200
WOODBURY MN, 55125-4925, US
Phone (651) 968-5042
Fax (651) 968-5903
Toxanomy
Taxonomy Code 363A00000X
License State Nebraska
License Number 1706
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According to our database, Ms. Abigail Mae Clark PA-C NPI is 1740528611, taxonomy code is 363A00000X and license number is 1706, license state is located at Nebraska. Abigail Mae Clark PA-C physically located at 2090 Woodwinds Dr, Woodbury MN, 55125-2522. NPI Number Abigail Mae Clark PA-C has the Individual type.

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1740528611 NPI number is provided on an as is basis without warranty of any kind. 1740528611 is maintained by the National Plan & Provider Enumeration System. The contents of Abigail Mae Clark PA-C are for informational purposes only.