NPI | 1700384930 |
---|---|
Entity Type | Organization |
Authorized Contact | SCOTT A CLARK Dpm 801-505-5277 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 106339-0501) |
Enumeration Date | 2018-01-23 |
Last Update Date | 2019-09-03 |