Logan S Clark, PA-C

NPI #1154593275 in Magna, Utah

Provider Information

NPI Number: 1154593275
Entity Type: Individual
Name: Logan S Clark, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Mar 28, 2008
Last Updated: Mar 28, 2008

Practice Location

Address: 8211 W 3500 S
City: Magna
State: Utah
ZIP Code: 84044-1851
Phone: (801) 250-9638

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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