Individual
DR. JESSEY DEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
627 GALLATIN ROAD, MADISON, TN 37115
(615) 865-0010
Mailing address
627 GALLATIN ROAD, MADISON, TN 37115
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000039519
TN
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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