Individual
MRS. MONICA DARICE CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
100 MONROE STREET, ANOKA, MN 55303
(763) 421-5540
Mailing address
13062 THRUSH STREET NW, COON RAPIDS, MN 55448
(763) 862-0893
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
117860
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1171860
MN BOARD OF PHARMACY
MN
Enumeration date
06/17/2005
Last updated
07/08/2007
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