Individual
ELIZABETH JEWELL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3608 S LAFOUNTAIN ST, KOKOMO, IN 46902-3809
(765) 455-2191
Mailing address
PO BOX 491, WINDFALL, IN 46076-0491
(765) 425-6544
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26027977A
IN
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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