Individual
TANNER CODY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
703 RIVERWAY PLACE, BEDFORD, NH 03110, NH 03110
(603) 627-1661
(603) 669-6944
Mailing address
703 RIVERWAY PLACE, BEDFORD, NH 03110, NH 03110
(603) 627-1661
(603) 669-6944
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24268
NH
2085R0202X
Diagnostic Radiology Physician
MD60961230
WA
Other
Enumeration date
04/11/2015
Last updated
09/08/2023
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