Individual
CLARK JOHN BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
614 W 2600 S, WOODS CROSS, UT 84087
(801) 299-2124
(801) 299-1634
Mailing address
614 W 2600 S, WOODS CROSS, UT 84087
(801) 298-2124
(801) 299-1634
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
150648
UT
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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