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JUSTIN CLARK PHARM.D.

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1942531868

Individual Registrant:
 JUSTIN  CLARK PHARM.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
12050 N DOVE MT BLVD  MARANA, AZ 85658 US
Tel: 520-225-0770  Fax: 520-225-0776

Contact information for business:
1301 W LAMBERT LN APT 9203  ORO VALLEY, AZ 85737-7114 US
Tel: --  Fax: --

Registration Information:
NPI: 1942531868
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
AZS016609
N183500000XPharmacy Service Providers
Pharmacist
NMRP00007152

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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