Individual
PAUL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
451 E BISHOP FEDERAL LN, SALT LAKE CITY, UT 84115-2357
(801) 487-7557
Mailing address
9956 S BLOSSOM DR, SANDY, UT 84092-3614
(385) 436-0546
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
9129425-4003
UT
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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