Individual
MRS. ELIZABETH ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-2071
Mailing address
7 WOODHILL LN, NORTH OAKS, MN 55127-2140
(651) 490-1586
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4616
MN
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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