Individual
CLARENCE PEACOCK ELLISON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1103 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2957
(919) 735-0400
(919) 735-3530
Mailing address
1103 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2957
(919) 735-0400
(919) 735-3530
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10902
NC
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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