Rick C. Clark JR., PA

NPI #1033190533 in Malad City, Idaho

Provider Information

NPI Number: 1033190533
Entity Type: Individual
Name: Rick C. Clark JR., PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Nov 10, 2005
Last Updated: Nov 16, 2021

Practice Location

Address: 220 BANNOCK ST
Address 2: SUITE 306
City: Malad City
State: Idaho
ZIP Code: 83252-1256
Phone: (208) 766-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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