Individual
JORDAN LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3000 S STATE ROAD 135, GREENWOOD, IN 46143-9825
(317) 535-4075
Mailing address
6576 CARESSA WAY, INDIANAPOLIS, IN 46259-1473
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
26027060A
IN
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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