Individual
TERRY R CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 28 3/4 RD, GRAND JUNCTION, CO 81501-5016
(970) 241-6023
(970) 242-8330
Mailing address
PO BOX 40, GLENWOOD SPRINGS, CO 81602-0040
(970) 945-2241
(970) 945-5523
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6241
CO
Other
Enumeration date
05/22/2006
Last updated
08/04/2008
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