Individual
CLINTON CHARLES MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
650 ELM ST., PAGE, AZ 86040
(928) 645-5714
Mailing address
650 ELM ST., PAGE, AZ 86040
(928) 645-5714
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S016638
AZ
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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