CHAD JEREMY CLARK

PARK CITY, UT
NPI1346339496
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: UT  8984876-1204)
Additional Taxonomies207Q00000X Family Medicine
(Licence: CO  46699)
207V00000X Obstetrics & Gynecology
(Licence: HI  DOS994)
Enumeration Date2006-10-12
Last Update Date2023-04-20
Business Address
-- CHAD JEREMY CLARK D.O.
900 ROUND VALLEY DR SUITE 200
PARK CITY, UT 84060-7552
Phone number: 435-658-7400
Mailing Address
-- CHAD JEREMY CLARK D.O.
PO BOX 30180
SALT LAKE CITY, UT 84130-0180
Phone number: 719-330-7854