Individual
MARCO CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2032 9TH AVE, GREELEY, CO 80631-1614
(970) 402-2746
Mailing address
2025 9TH AVE, GREELEY, CO 80631-1614
(970) 402-2746
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0001708
CO
246Z00000X
Other Specialist/Technologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
CO
Other
Enumeration date
12/03/2016
Last updated
08/21/2017
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