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Individual
JUSTIN CLARK
Active
Individual
JUSTIN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH.0021616
CO
183500000X
Pharmacist
RP00007152
NM
183500000X
Pharmacist
S016609
AZ
Other
Enumeration date
01/15/2010
Last updated
01/05/2023
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