Individual
MARCIA MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 13TH ST NW, EAST GRAND FORKS, MN 56721-1473
(218) 773-2579
Mailing address
720 13TH ST NW, EAST GRAND FORKS, MN 56721-1473
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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