Organization
GARY W. CLARK A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY W. CLARK DPM (OWNER)
(888) 437-3668
Entity
Organization
Contact information
Practice address
444 S. MAIN, MILFORD, UT 84751
(888) 437-3668
Mailing address
166 W 1325 N STE 300, CEDAR CITY, UT 84720-7854
(435) 867-8521
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
3207290501
UT
Other
Enumeration date
11/14/2006
Last updated
08/22/2020
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