MR. Douglas Lee Clark

NPI #1760735328 in Minocqua, Wisconsin

Provider Information

NPI Number: 1760735328
Entity Type: Individual
Name: MR. Douglas Lee Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Oct 19, 2012
Last Updated: Oct 19, 2012

Practice Location

Address: 9750 HIGHWAY 70
City: Minocqua
State: Wisconsin
ZIP Code: 54548-9753
Phone: (715) 356-9449

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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