Individual
CLARK ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
(901) 545-6078
(901) 545-7557
Mailing address
877 JEFFERSON AVE, MEMPHIS, TN 38103-2807
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
39242
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39242
TENNESSEE STATE LICENSE
TN
Enumeration date
12/06/2018
Last updated
12/06/2018
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