Individual
MS. KATHLEEN M CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
209 COMMERCIAL ST, HARTLAND, ME 04943-3710
(207) 938-4880
(207) 938-4880
Mailing address
209 COMMERCIAL ST, HARTLAND, ME 04943-3710
(207) 938-4880
(207) 938-4880
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
CR567
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015106
BCBS
ME
Enumeration date
09/07/2005
Last updated
07/08/2007
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