Individual
MR. JASON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3021 REIDVILLE RD, SPARTANBURG, SC 29301-5643
(864) 576-9201
(864) 576-6584
Mailing address
552 VERDAE DR, SPARTANBURG, SC 29301-5384
(864) 237-2099
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
009365
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009365
PHARMACIST
SC
Enumeration date
07/14/2011
Last updated
06/19/2012
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