Individual
DR. KELLY JANE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
328 QUAIL WALK TRL, CHAPIN, SC 29036-9791
(803) 935-9702
(803) 935-4564
Mailing address
328 QUAIL WALK TRL, CHAPIN, SC 29036-9791
(803) 935-9702
(803) 935-4564
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10283
SC
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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