Individual
MR. MICHAEL ALLEN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
9501 E SHEA BLVD, SCOTTSDALE, AZ 85260-6719
(480) 551-8639
Mailing address
1326 N WILBUR, MESA, AZ 85201-2705
(480) 827-8495
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9796
AZ
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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