CLARK JOSEPH WYATT

TWIN FALLS, ID
NPI1215448246
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: ID  57139)
Enumeration Date2017-10-17
Last Update Date2020-11-17
Business Address
CLARK JOSEPH WYATT NP-C
1502 LOCUST ST N STE 600
TWIN FALLS, ID 83301-4164
Phone number: 208-734-6091
Mailing Address
CLARK JOSEPH WYATT NP-C
1131 COLE ST
KIMBERLY, ID 83341-5138
Phone number: 208-490-1901