Individual
DIANE ADELE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 10TH ST, FLORESVILLE, TX 78114-1851
(830) 393-8098
Mailing address
925 10TH ST, FLORESVILLE, TX 78114-1851
(830) 393-8098
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
187925
TX
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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