Individual
ALLAN W CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 153, MADISON, WI 53792-0001
(608) 263-1290
Mailing address
2136 COMMONWEALTH AVE, MADISON, WI 53726-3956
(608) 238-8212
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9007
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9007
PHARMACIST
WI
Enumeration date
11/09/2006
Last updated
07/08/2007
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