Individual
DOUGLAS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
25140 E US HIGHWAY 50, PUEBLO, CO 81006-9775
(719) 544-1371
Mailing address
693 S MCCOY DR, PUEBLO WEST, CO 81007-1720
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0020582
CO
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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