Individual
AMANDA CLAIRE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
305 MAPLE DR, VIDALIA, GA 30474-8908
(912) 538-0053
Mailing address
305 MAPLE DR, VIDALIA, GA 30474-8908
(912) 538-0053
(912) 538-0498
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
023304
GA
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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