Individual
JESSICA LYNN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1175 E 3200 N, LEHI, UT 84043-5464
(801) 407-3000
Mailing address
1175 E 3200 N, LEHI, UT 84043-5464
(801) 407-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9149488-3102
UT
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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