Individual
ELIZA GUNN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
98 N 1100 E STE 402, AMERICAN FORK, UT 84003-2951
(801) 492-2405
Mailing address
758 E 900 N APT 106, PROVO, UT 84606-2105
(412) 716-0133
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12615494-2401
UT
225100000X
Physical Therapist
Primary
14032
CT
Other
Enumeration date
01/07/2022
Last updated
08/10/2023
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