Individual
CAROLYN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1210 WILSON RD, NEWBERRY, SC 29108-4008
(803) 276-6350
(803) 276-4064
Mailing address
1 GROVES WOOD CT, COLUMBIA, SC 29212-2847
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12798
SC
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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