Individual
TAYLOR CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
55 GOODMAN RD W, SOUTHAVEN, MS 38671-9447
(662) 349-1102
Mailing address
55 GOODMAN RD W, SOUTHAVEN, MS 38671-9447
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-101422
MS
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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