Individual
ERIKKA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
502 RAILROAD ST, ST JOHNSBURY, VT 05819-1633
(802) 748-5210
Mailing address
4002 DUCK POND RD, WATERFORD, VT 05819-9304
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
033.0104359
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033.0104359
PHARMACIST LICENSE
VT
Enumeration date
07/29/2014
Last updated
07/29/2014
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