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1568768950
JEREMIAH RUSSELL CLARK
SALT LAKE CITY, UT
NPI
1568768950
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2011-02-01
Last Update Date
2011-02-01
Business Address
-- JEREMIAH RUSSELL CLARK
5965 S 900 E
SALT LAKE CITY, UT 84121-1720
Phone number: 801-263-7150
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Mailing Address
-- JEREMIAH RUSSELL CLARK
5965 S 900 E
SALT LAKE CITY, UT 84121-1720
Phone number: 801-263-7150
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