Individual
MRS. HEIDI LYNN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
60 MDG/MDTS, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535-1809
(707) 423-3665
Mailing address
60 MDG/MDTS, 101 BODIN CIRCLE, TRAVIS AFB, CA 94535-1809
(707) 423-3665
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
08/04/2015
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