Individual
EMILY ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
366 S 500 E STE B, AMERICAN FORK, UT 84003-2526
(801) 855-5834
Mailing address
366 S 500 E STE B, AMERICAN FORK, UT 84003-2526
(801) 855-5834
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7815656-4701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962150425
GROUP NPI
UT
Enumeration date
06/06/2022
Last updated
06/15/2022
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