Individual
CAMERON TALMAGE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
388 MARTIN ST, TWIN FALLS, ID 83301-4544
(208) 734-0451
(208) 734-0452
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 734-3312
(208) 734-5036
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-696
ID
Other
Enumeration date
08/22/2007
Last updated
12/03/2012
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