Individual
WILL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1205 E BROADWAY ST, MISSOULA, MT 59802-4968
(406) 243-7811
Mailing address
72 SUSIE TABOR RD, SCOTTSVILLE, KY 42164-9425
(270) 619-1398
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
E3919822
MT
Other
Enumeration date
09/19/2025
Last updated
09/19/2025
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