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Individual

CLARK JACOB THORNTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1912 W 930 N, PLEASANT GROVE, UT 84062-4104
(801) 492-1999
Mailing address
1912 W 930 N, PLEASANT GROVE, UT 84062-4104

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13244483-8905
UT

Other

Enumeration date
04/09/2020
Last updated
07/06/2023
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