Individual
DR. CLARENCE RICHARD HENRIKSEN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 CHIPETA WAY, STE A, SALT LAKE CITY, UT 84132-0001
(801) 581-8000
Mailing address
375 CHIPETA WAY, STE A, SALT LAKE CITY, UT 84132-0001
(801) 581-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7152595-1205
UT
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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