Individual
JOSHUA MILES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RMT
Contact information
Practice address
1050 S DAHLIA ST APT C19, GLENDALE, CO 80246-2829
(435) 313-5155
Mailing address
1050 S DAHLIA ST APT C19, GLENDALE, CO 80246-2829
(435) 313-5155
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT .0008738
CO
Other
Enumeration date
05/17/2014
Last updated
05/17/2014
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