Individual
ELIZABETH G CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
77 MALLETT DR, TOPSHAM, ME 04086-1300
(207) 729-0806
(207) 725-8293
Mailing address
77 MALLETT DR, TOPSHAM, ME 04086-1300
(207) 729-0806
(207) 725-8293
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR46176
ME
183700000X
Pharmacy Technician
188647
ME
Other
Enumeration date
06/17/2016
Last updated
09/03/2016
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