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Individual

DR. CLINTON H CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
520 S EAGLE RD, STE 1243, MERIDIAN, ID 83642-6351
(208) 938-4670
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
(208) 938-4675

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P191
ID

Other

Enumeration date
06/01/2006
Last updated
02/21/2014
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