| NPI | 1598205494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A CLARK Dpm/Owner 801-505-0821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 8926321-0501) |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2020-04-21 |