NPI 1053683078
Kyle Clark
Practice location
- Address
- 196 Arrowhead Dr STE 6, Evanston, WY 82930-8752
- Phone
- (307) 789-4224
- Fax
- (307) 789-4225
Registered specialties
Community Health Worker
Primary
Registry record
- NPI
- 1053683078
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 7 Feb 2012
- Record last updated
- 7 Feb 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.