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1649687948
VICTOR CLARK
HERRIMAN, UT
NPI
1649687948
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
310400000X Assisted Living Facility
(Licence: UT 2014-ALIIUT000651)
Enumeration Date
2014-07-18
Last Update Date
2014-07-18
Business Address
VICTOR CLARK
6352 W 13100 S
HERRIMAN, UT 84096
Phone number: 801-903-1040
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Mailing Address
VICTOR CLARK
6352 W 13100 S
HERRIMAN, UT 84096
Phone number: 801-903-1040
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