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Individual

EARL CLAYCOMB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
OLD ROUTE 119, MOUNT GAY, WV 25637
(304) 752-1445
(304) 752-1468
Mailing address
2428 ASTARITA WAY, LEXINGTON, KY 40509-4463
(859) 523-2613

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP 0003750
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0138875000
WV
Enumeration date
11/24/2006
Last updated
07/08/2007
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