Bryan A Clark PA

NPI 1093777047 - Physician Assistant - 363AM0700X

NPI Details
NPI 1093777047
Gender Male
Enumeration Date 04/05/2006
Last Updated 04/22/2016
Entity Type Individual
Active Over 10 years ago
Practice Location
9844 S 1300 E
STE 275
SANDY UT, 84094-4692, US
Phone (801) 571-7061
Fax (801) 571-9277
Business Location
PO BOX 27128
SALT LAKE CITY UT, 84127-0128, US
Phone (801) 571-7061
Fax (801) 571-9277
Toxanomy
Taxonomy Code 363AM0700X
License State Utah
License Number 3231151206
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According to our database, Bryan A Clark PA NPI is 1093777047, taxonomy code is 363AM0700X and license number is 3231151206, license state is located at Utah. Bryan A Clark PA physically located at 9844 S 1300 E, Sandy UT, 84094-4692. NPI Number Bryan A Clark PA has the Individual type.

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1093777047 NPI number is provided on an as is basis without warranty of any kind. 1093777047 is maintained by the National Plan & Provider Enumeration System. The contents of Bryan A Clark PA are for informational purposes only.