Individual
LESLIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 BROOKLINE AVE, SHAPIRO ROOM 941, BOSTON, MA 02215-5400
(617) 667-5043
Mailing address
330 BROOKLINE AVE, SHAPIRO ROOM 941, BOSTON, MA 02215-5400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
25808
MA
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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