IndividualActive
Gregory Clark, P.A.
NPI 1730170796 · Physician Assistant · Powell, WY
Provider details
- NPI number
- 1730170796
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- P.A.
- Sex
- Male
- Sole proprietor
- No
- License
- 203 (WY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
777 Avenue H
Powell Valley Healthcare Inc
Powell, WY 82435
Phone: (307) 754-3405
Fax: (307) 754-1207
Approximate (ZIP-level) locationGet directions
Mailing address
777 Avenue H
Powell, WY 82435
Registry dates
- Enumerated
- 2005-10-31
- Last updated
- 2015-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.