Individual
HANNAH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 N 1900 E, SALT LAKE CITY, UT 84132-0002
(231) 463-4902
Mailing address
2483 E 2900 S, SALT LAKE CITY, UT 84109-1855
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12635246-1206
UT
Other
Enumeration date
04/25/2022
Last updated
02/15/2024
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