Kyle Clark

NPI #1053683078 in Evanston, Wyoming

Provider Information

NPI Number: 1053683078
Entity Type: Individual
Name: Kyle Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Community Health Worker
Enumeration Date: Feb 7, 2012
Last Updated: Feb 7, 2012

Practice Location

Address: 196 ARROWHEAD DR STE 6
City: Evanston
State: Wyoming
ZIP Code: 82930-8752
Phone: (307) 789-4224

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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