Individual
KELSEY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1362 W MAIN ST, WHITEWATER, WI 53190-1504
(262) 473-7740
Mailing address
1362 W MAIN ST, WHITEWATER, WI 53190-1504
(262) 473-7740
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17484
WI
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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