Individual
MR. JOHN JACOB CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1312 NORTHLAND DRIVE, MENDOTA HEIGHTS, MN 55120
(888) 341-1542
Mailing address
1312 NORTHLAND DRIVE, MENDOTA HEIGHTS, MN 55120
(888) 341-1542
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120455
MN
183500000X
Pharmacist
16503-40
WI
Other
Enumeration date
12/20/2011
Last updated
10/30/2017
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