Organization · Type 2 NPI
Gary W. Clark A Professional Corporation
Customized Equipment (DME) · Beaver, UT
NPI number
1679646319
Active
Practice location
55 N 400 E
Beaver, UT 84713
Mailing address
166 W 1325 N Ste 300
Cedar City, UT 84720-7854
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Customized Equipment (DME) Primary | 332BC3200X | 3207290501 (UT) |
Customized Equipment (DME): Definition to come...
Another provider at this address
About NPI 1679646319
Gary W. Clark A Professional Corporation's National Provider Identifier is 1679646319, issued on Nov 17, 2006. The primary taxonomy on file is Customized Equipment (DME) (332BC3200X), and the practice location is in Beaver, UT. The record was last updated on Aug 22, 2020.