Individual
AMANDA LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
260 DELAWARE AVE, DELMAR, NY 12054-1123
(518) 439-9356
Mailing address
260 DELAWARE AVE, DELMAR, NY 12054-1123
(518) 439-9356
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
059398
NY
Other
Enumeration date
08/03/2014
Last updated
08/03/2014
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