STACY CLARK

SOUTH BEND, IN
NPI1689950479
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: MI  5302026870)
Additional Taxonomies183500000X Pharmacist
(Licence: IN  26016810)
Enumeration Date2011-10-25
Last Update Date2011-10-25
Business Address
STACY CLARK RPH
52482 STATE ROAD 933
SOUTH BEND, IN 46637-3852
Phone number: 574-271-0357
Mailing Address
STACY CLARK RPH
52482 STATE ROAD 933
SOUTH BEND, IN 46637-3852
Phone number: 574-271-0357