MR. Tony Dale Clark

NPI #1821685157 in Lenexa, Kansas

Provider Information

NPI Number
1821685157
Entity Type
Individual
Name
MR. Tony Dale Clark
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Pharmacist
Enumeration Date
Dec 21, 2020
Last Updated
Dec 21, 2020

Practice Location

Address
12200 W 95TH ST
City
Lenexa
State
Kansas
ZIP Code
66215-3806
Phone
(913) 894-2093

Specialties & Taxonomy Codes

Specialty
Pharmacist

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