Individual
MARY CHRISTINE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RCP, IBCLC
Contact information
Practice address
2774 230TH ST, CUSHING, WI 54006-3421
(715) 808-2603
Mailing address
2774 230TH ST, CUSHING, WI 54006-3421
(715) 808-2603
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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