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Individual

DILLON CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
921 S 8TH AVE, POCATELLO, ID 83209-8105
(208) 282-4636
Mailing address
1002 SAMUEL ST TRLR 111, POCATELLO, ID 83204-2091

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
01/21/2026
Last updated
01/21/2026
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