Individual
RAND J. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
560 SHOUP AVE W, TWIN FALLS, ID 83301-5029
(208) 737-2126
Mailing address
2093 BOULDER CIR, TWIN FALLS, ID 83301-8344
(208) 734-3429
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
626
ID
Other
Enumeration date
11/24/2008
Last updated
11/25/2008
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