Individual
MR. DONALD DALE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
2305 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-3920
(270) 796-3909
(270) 796-4111
Mailing address
2305 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-3920
(270) 796-3909
(270) 796-4111
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6873
KY
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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