Individual provider · Type 1 NPI

Tyler Clark

Student in an Organized Health Care Education/Training Program · St. Louis, MO

NPI number 1407308018 Active

Practice location

7785 Keswick Pl
St. Louis, MO 63119

Call (573) 344-7009 Map

Mailing address

1900 Mcnatt Dr Apt 1
Brookland, AR 72417-9024

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1407308018

Tyler Clark's National Provider Identifier is 1407308018, issued on Oct 30, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in St. Louis, MO. The record was last updated on Jun 18, 2018.