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Individual

SAMANTHA CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM D

Contact information

Practice address
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401-7201
(601) 288-4286
(601) 288-4163
Mailing address
312 S 17TH AVE, HATTIESBURG, MS 39401-6253
(601) 297-7501

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-12595
MS

Other

Enumeration date
11/14/2018
Last updated
11/14/2018
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