Clark, Marissa

Clark, Marissa is an individual health care provider with primary practice located at 112 Mansfield Ave , Willimantic CT 06226-2040. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Clark, Marissa can be contacted via phone (860) 456-9116.

Contact Information

Primary practice address
112 Mansfield Ave Willimantic CT 06226-2040
Phone: (860) 456-9116
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1194387431
LBN Legal business name Clark, Marissa
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2019
Last updated Nov 6th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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