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1225458136
ROGER CLARK
PUEBLO, CO
NPI
1225458136
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: CO 627)
Enumeration Date
2014-04-17
Last Update Date
2014-04-17
Business Address
Prof. ROGER CLARK ATC, PhD
2200 BONFORTE BLVD
PUEBLO, CO 81001-4901
Phone number: 719-549-2530
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Mailing Address
Prof. ROGER CLARK ATC, PhD
2200 BONFORTE BLVD
PUEBLO, CO 81001-4901
Phone number: 719-549-2530
Copy
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