Organization
ALPINE SPINAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY S CLARK DC (OWNER/CHIROPRACTIC PHYSICIAN)
(801) 374-2774
Entity
Organization
Contact information
Practice address
3325 N UNIVERSITY AVE STE 125, PROVO, UT 84604-6615
(801) 374-2774
(801) 292-7188
Mailing address
3325 N UNIVERSITY AVE STE 125, PROVO, UT 84604-6615
(801) 374-2774
(801) 292-7188
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1668441202
UT
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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