Individual
CLARK STILLAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
533 S LINCOLN AVE, YORK, NE 68467-4211
(402) 362-1280
(402) 362-1355
Mailing address
533 S LINCOLN AVE, YORK, NE 68467-4211
(402) 362-1280
(402) 362-1355
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10736
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10736
NEBRASKA STATE LICENSE 10736
NE
Enumeration date
06/14/2012
Last updated
06/14/2012
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