Individual
ESTE MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15667 88TH ST NE APT 210, OTSEGO, MN 55330-2960
(718) 598-0167
Mailing address
15667 88TH ST NE APT 210, OTSEGO, MN 55330-2960
(718) 598-0167
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
71740
MN
Other
Enumeration date
04/18/2019
Last updated
07/07/2022
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