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Individual

BRIAN THOMAS CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD.

Contact information

Practice address
608 E MOUNTAIN VIEW AVE, ELLENSBURG, WA 98926-3819
(509) 925-6996
Mailing address
608 E MOUNTAIN VIEW AVE, ELLENSBURG, WA 98926-3819
(509) 925-6996

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
P6871
ID
183500000X
Pharmacist
Primary
PH60419201
WA

Other

Enumeration date
07/01/2014
Last updated
07/01/2014
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