Individual
VICTOR CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6352 W 13100 S, HERRIMAN, UT 84096
(801) 903-1040
(801) 446-6293
Mailing address
6352 W 13100 S, HERRIMAN, UT 84096
(801) 903-1040
(801) 446-6293
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2014-ALIIUT000651
UT
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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