Individual
TYLER SCOTT CLARK
Active
Individual
TYLER SCOTT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
12267283-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
BP10059361
TX
Other
Enumeration date
04/17/2017
Last updated
12/08/2024
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