Individual
MR. SEAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
151 S COLLEGE AVE, SUITE A4, FORT COLLINS, CO 80524-2864
(970) 305-2197
(855) 300-9423
Mailing address
151 S COLLEGE AVE, SUITE A4, FORT COLLINS, CO 80524-2864
(970) 305-2197
(855) 300-9423
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT.0016060
CO
Other
Enumeration date
04/12/2007
Last updated
04/20/2015
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