Individual
CHRISTINA MAE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
25A JUNE STREET, SANFORD, ME 04073
(207) 324-1488
Mailing address
57 JAMES ST, WELLS, ME 04090-6151
(207) 651-8072
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAN374
ME
363AS0400X
Surgical Physician Assistant
PAN374
ME
Other
Enumeration date
08/29/2019
Last updated
05/08/2024
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