Individual
THOMAS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH,MBA
Contact information
Practice address
429 DELAWARE ST, LEAVENWORTH, KS 66048-2732
(913) 651-7455
(913) 682-4220
Mailing address
429 DELAWARE ST, LEAVENWORTH, KS 66048-2732
(913) 651-7455
(913) 682-4220
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-09492
KS
Other
Enumeration date
07/30/2013
Last updated
07/30/2013
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