Individual
DR. BROOKE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6237 S 20TH GLN, PHOENIX, AZ 85041-5434
(602) 770-2854
Mailing address
6237 S 20TH GLN, PHOENIX, AZ 85041-5434
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
IN0002854
NM
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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