Individual
JULIE W. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CDE
Contact information
Practice address
106 W WASHINGTON ST., JEFFERSON, IA 50129-1920
(515) 386-4153
(515) 386-0364
Mailing address
106 W WASHINGTON ST., JEFFERSON, IA 50129-1920
(515) 386-4153
(515) 386-0364
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1002
IA
Other
Enumeration date
05/15/2009
Last updated
05/08/2015
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