MRS. Heidi Lynn Clark, RD

NPI #1720154701 in Travis Afb, California

Provider Information

NPI Number: 1720154701
Entity Type: Individual
Name: MRS. Heidi Lynn Clark, RD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dietitian, Registered
Credential: RD
Enumeration Date: Nov 28, 2006
Last Updated: Aug 4, 2015

Practice Location

Address: 60 MDG/MDTS
Address 2: 101 BODIN CIRCLE
City: Travis Afb
State: California
ZIP Code: 94535-1809
Phone: (707) 423-3665

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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