| NPI | 1396221255 |
|---|---|
| Professional Name | DWAYNE CLACKS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2020-11-10 |