Most Relevant Information
Provider Data
| NPI Number: | 1003363946 |
| Provider Name: | VANESSA CLARK PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | RPH026654 |
Most Important Dates
| Enumeration Date: | 09/08/2016 |
| Last Updated: | 09/08/2016 |
Provider Practice Location
1308 S HARRIS ST
SANDERSVILLE
GA
310826913
Practice Location Phone/Fax
| Phone: | 4785527063 |
| Fax: | 4785530939 |
Provider Mailing Location
1308 S HARRIS ST
SANDERSVILLE
GA
310826913
Provider Mailing Phone/Fax
| Phone: | 4785527063 |
| Fax: | 4785530939 |