Individual
CLARKE TATJE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
220 FRONT ST, PONTE VEDRA BEACH, FL 32082-5022
(904) 280-5440
Mailing address
304 W SILVERTHORN LN, PONTE VEDRA, FL 32081-7003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS59719
FL
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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