Individual
ELIZABETH KAITLYN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD RPH
Contact information
Practice address
1029 S M 37, TRAVERSE CITY, MI 49685-8508
(231) 943-3147
Mailing address
5477 EXODUS DR, TRAVERSE CITY, MI 49684-8353
(231) 715-0090
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302039919
MI
Other
Enumeration date
06/07/2020
Last updated
06/07/2020
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