Individual
SAMANTHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
63 NEWPORT AVE, RUMFORD, RI 02916-2020
(401) 431-0461
Mailing address
63 NEWPORT AVE, RUMFORD, RI 02916-2020
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
29754
NC
Other
Enumeration date
10/09/2020
Last updated
05/21/2021
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