Clark, John Jacob

Clark, John Jacob is an sole proprietor health care provider with primary practice located at 1312 Northland Drive , Mendota Heights MN 55120. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Clark, John Jacob can be contacted via phone (888) 341-1542.

Contact Information

Primary practice address
1312 Northland Drive Mendota Heights MN 55120
Phone: (888) 341-1542
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 16503-40 Wisconsin
Pharmacy Service Providers / Pharmacist 183500000X 120455 Minnesota

Profile Details

NPI number 1427327428
LBN Legal business name Clark, John Jacob
Credentials PHARM.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2011
Last updated Oct 30th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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