Individual
DR. JUSTIN JOHN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3945 E SOUTHERN AVE, PHOENIX, AZ 85040-3961
(602) 426-0501
(602) 426-0567
Mailing address
3945 E SOUTHERN AVE, PHOENIX, AZ 85040-3961
(602) 426-0501
(602) 426-0567
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S017466
AZ
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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