Individual
MR. PAUL GRAHAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 N KENTUCKY AVE, WEST PLAINS, MO 65775-2029
(417) 256-9111
(417) 257-6727
Mailing address
418 COUNTY ROAD 804, GAMALIEL, AR 72537-9767
(870) 467-5733
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
044351
MO
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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