| NPI | 1598205494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A CLARK Dpm 801-505-0821 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2025-10-27 |