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Individual

LISA A CLARCQ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 873-1098
(207) 861-5461
Mailing address
149 NORTH ST, WATERVILLE, ME 04901-4974
(207) 873-1098
(207) 861-5461

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1610
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
154420000
ME
Enumeration date
03/26/2007
Last updated
01/20/2021
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