Individual
NATHAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(720) 536-7961
Mailing address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
16922
CO
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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