Jerry S. Clark, D.C.

Chiropractor · Provo, UT

Individual Active NPI

NPI number 1114082872

Practice location

3325 N University Ave Ste 125
Provo, UT 84604-6615
Phone
(801) 374-2774
Fax
(801) 374-2775

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NPI record

NPI
1114082872
Entity type
Individual (Type 1)
Enumeration date
December 23, 2006
Last updated
November 1, 2016
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Chiropractor Primary 111N00000X 166844-1202 UT

About Dr. Clark

Jerry S. Clark, D.C. is a healthcare provider registered in the NPI registry with the primary taxonomy Chiropractor (code 111N00000X). The practice location is 3325 N University Ave Ste 125, Provo, UT 84604-6615. The NPI number 1114082872 was assigned on December 23, 2006 and the record was last updated on November 1, 2016.

Dr. Clark lists a license in the registry: #166844-1202 (UT) for Chiropractor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jerry S. Clark, D.C.?

The NPI number is 1114082872.

What is the phone number of Dr. Clark?

The phone number listed for the practice location is (801) 374-2774.

Where is Dr. Clark located?

3325 N University Ave Ste 125, Provo, UT 84604-6615.

What is the taxonomy code for Dr. Clark?

The primary taxonomy code is 111N00000X – Chiropractor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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