Individual
DR. CHARLOTTE ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
730 E 2ND ST, APT. 3, WINONA, MN 55987-4400
(507) 454-0903
(507) 454-0600
Mailing address
730 E 2ND ST, APT. 3, WINONA, MN 55987-4400
(507) 454-0903
(507) 454-0600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41455
MN
Other
Enumeration date
07/28/2009
Last updated
07/28/2009
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