Individual
TYLER JOHN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D
Contact information
Practice address
940 BELMONT ST, FOOD AND NUTRITION SERVICES, BROCKTON, MA 02301-5596
(774) 826-1439
Mailing address
940 BELMONT ST, FOOD AND NUTRITION SERVICES, BROCKTON, MA 02301-5596
(774) 826-1439
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3061
MA
Other
Enumeration date
03/05/2010
Last updated
05/06/2015
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