Individual
MICHAEL J CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
270 MAIN ST, MAMMOTH SPRING, AR 72554-7466
(870) 625-3222
Mailing address
270 MAIN ST, MAMMOTH SPRING, AR 72554-7466
(870) 625-3222
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
2013026461
MO
183500000X
Pharmacist
Primary
PD12709
AR
Other
Enumeration date
07/27/2013
Last updated
11/27/2020
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