Individual
MRS. DONNA LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
124 MAIN ST, MAN PHARMACY, MAN, WV 25635-1212
(304) 583-9910
(304) 583-9929
Mailing address
PO BOX 33 JEWEL STREET, PROCTOR BOTTOM, AMHERSTDALE, WV 25607
(304) 583-7184
(304) 583-9929
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0005874
WV
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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