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Individual

DR. TERRY K CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4976 E MEADOWS DR, PARK CITY, UT 84098-5921
(435) 602-9767
(413) 683-9923
Mailing address
PO BOX 982255, PARK CITY, UT 84098-2255
(435) 602-9767
(413) 683-9923

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2480
AK

Other

Enumeration date
04/20/2009
Last updated
04/20/2009
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