Individual
WILLIAM O. CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1174 E GRAYSTONE WAY STE 20G, SALT LAKE CITY, UT 84106-2678
(801) 793-9435
Mailing address
2979 W 3835 S, WEST VALLEY, UT 84119-4557
(801) 793-9435
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9740409-4701
UT
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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