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Individual

MARY CLINTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1370 EASTON AVE, SOMERSET, NJ 08873-1413
(732) 306-0378
Mailing address
1370 EASTON AVE, SOMERSET, NJ 08873-1413
(732) 306-0378

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
297103
NJ

Other

Enumeration date
09/30/2009
Last updated
09/30/2009
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