OrganizationActive
Gary W. Clark a Professional Corporation
NPI 1679646319 · Customized Equipment (DME) · Beaver, UT
Provider details
- NPI number
- 1679646319
- Entity type
- Organization
- Primary specialty
- Customized Equipment (DME)Suppliers
- Organization subpart
- No
- Authorized official
- Gary Clark, Owner(435) 867-8521
- License
- 3207290501 (UT)
Specialties & taxonomies
Suppliers
Practice location
55 N 400 E
Beaver, UT 84713
Phone: (888) 437-3668
Approximate (ZIP-level) locationGet directions
Mailing address
166 W 1325 N Ste 300
Cedar City, UT 84720-7854
Registry dates
- Enumerated
- 2006-11-17
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.