JOHN CLARK

IDAHO FALLS, ID
NPI1811301617
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
(Licence: ID  LSW1381)
Enumeration Date2014-06-19
Last Update Date2014-06-19
Business Address
-- JOHN CLARK LSW
540 3RD ST
IDAHO FALLS, ID 83401-3953
Phone number: 208-524-5607
Mailing Address
-- JOHN CLARK LSW
3791 E DEER CRK
IDAHO FALLS, ID 83401-6804
Phone number: 208-403-1327