Individual
MR. JOE H CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
11470 KATIE DR, PASS CHRISTIAN, MS 39571-5305
(228) 255-2886
Mailing address
11470 KATIE DR, PASS CHRISTIAN, MS 39571-5305
(228) 255-2886
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E05858
MS
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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