Individual
MRS. TERESA JOAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
526 SOUTHGATE AVE, IOWA CITY, IA 52240-4426
(319) 354-3824
(319) 354-3826
Mailing address
9140 DEER VALLEY DR, CEDAR RAPIDS, IA 52411-8138
(319) 390-9012
(319) 390-9071
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01075
IA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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