Individual
CLARK MELVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
27322 CARRONADE DR, PERRYSBURG, OH 43551-3368
(567) 336-4658
Mailing address
4337 MOSER LN, PERRYSBURG, OH 43551-7188
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03237275
OH
Other
Enumeration date
12/07/2017
Last updated
12/07/2017
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