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1750805982
MICHELLE RUTH CLARK
PORTLAND, ME
NPI
1750805982
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ME PAN1716)
Enumeration Date
2017-07-30
Last Update Date
2017-07-30
Business Address
MICHELLE RUTH CLARK PA-C
144 STATE ST
PORTLAND, ME 04101-3776
Phone number: 207-899-5322
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Mailing Address
MICHELLE RUTH CLARK PA-C
77 DANFORTH ST APT 2
PORTLAND, ME 04101-3588
Phone number:
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