Individual
HENRY R CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
44199 MONROE ST STE A, INDIO, CA 92201-3096
(760) 347-0754
Mailing address
44199 MONROE ST STE A, INDIO, CA 92201-3096
(760) 347-0754
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
06/12/2025
Last updated
01/28/2026
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