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1164763124
MICHAEL T CLARK
AUSTIN, TX
NPI
1164763124
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: TX 22549)
Enumeration Date
2013-03-14
Last Update Date
2013-03-14
Business Address
Mr. MICHAEL T CLARK rph
2400 S CONGRESS AVE
AUSTIN, TX 78704-5512
Phone number: 512-442-1578
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Mailing Address
Mr. MICHAEL T CLARK rph
2400 S CONGRESS AVE
AUSTIN, TX 78704-5512
Phone number: 512-442-1578
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