Gregory P Clark, P.A.

NPI #1730170796 in Powell, Wyoming

Provider Information

NPI Number
1730170796
Entity Type
Individual
Name
Gregory P Clark, P.A.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Credential
P.A.
Enumeration Date
Oct 31, 2005
Last Updated
May 13, 2015

Practice Location

Address
777 AVENUE H
Address 2
POWELL VALLEY HEALTHCARE INC
City
Powell
State
Wyoming
ZIP Code
82435
Phone
(307) 754-3405

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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