Individual
SARAH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2705 E 17TH ST, AMMON, ID 83406-6669
(208) 346-7500
(307) 333-0470
Mailing address
1621 E 49TH S APT 2107, IDAHO FALLS, ID 83404-7897
(208) 403-4364
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
163
ID
175T00000X
Peer Specialist
Primary
163
WY
Other
Enumeration date
04/17/2024
Last updated
07/13/2026
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