Individual
DR. MARY LISA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
3311 HWY 54, OWENSBORO, KY 42303-2120
(270) 926-0476
Mailing address
6506 LITTLE HICKORY RD, PHILPOT, KY 42366-9046
(270) 314-7899
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
011797
KY
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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