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1891749768
TERRY R CLARK
GRAND JUNCTION, CO
NPI
1891749768
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CO 6241)
Enumeration Date
2006-05-22
Last Update Date
2008-08-04
Business Address
-- TERRY R CLARK
515 28 3/4 RD
GRAND JUNCTION, CO 81501-5016
Phone number: 970-241-6023
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Mailing Address
-- TERRY R CLARK
PO BOX 40
GLENWOOD SPRINGS, CO 81602-0040
Phone number: 970-945-2241
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