Individual
RICHARD JACK CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT
Contact information
Practice address
68 S 600 E, SALT LAKE CITY, UT 84102-1007
(801) 428-3244
Mailing address
68 S 600 E, SALT LAKE CITY, UT 84102-1007
(801) 428-3244
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
#518
UT
Other
Enumeration date
05/10/2016
Last updated
05/11/2016
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