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1114082872
JERRY S CLARK
PROVO, UT
NPI
1114082872
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
111N00000X Chiropractor
(Licence: UT 166844-1202)
Enumeration Date
2006-12-23
Last Update Date
2016-11-01
Business Address
-- JERRY S CLARK D.C.
3325 N UNIVERSITY AVE STE 125
PROVO, UT 84604-6615
Phone number: 801-374-2774
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Mailing Address
-- JERRY S CLARK D.C.
3325 N UNIVERSITY AVE STE 125
PROVO, UT 84604-6615
Phone number: 801-374-2774
Copy
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