Individual
MICHAEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 374-1720
Mailing address
417 5TH ST, MARIETTA, OH 45750-2012
(740) 516-0059
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03225234
OH
1835P1200X
Pharmacotherapy Pharmacist
Primary
03225234
OH
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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