Individual
ANDREA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RENAL DIETITIAN
Contact information
Practice address
720 S RIVER RD STE D1100, ST GEORGE, UT 84790-5522
(435) 656-0857
Mailing address
85 MEDICAL DR # 201, SALT LAKE CITY, UT 84112-1100
(801) 581-8578
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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