Individual
ANDRAYA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
289 IRELAND AVE, FORT KNOX, KY 40121-5111
(502) 624-9222
Mailing address
289 IRELAND AVE, FORT KNOX, KY 40121-5111
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
015101
KY
Other
Enumeration date
08/08/2017
Last updated
08/08/2017
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