Most Relevant Information
Provider Data
| NPI Number: | 1003678723 |
| Provider Name: | SHYLIEA RAIN CLARK |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/29/2024 |
| Last Updated: | 01/29/2024 |
Provider Practice Location
2853 NORTH AVE
GRAND JUNCTION
CO
815015040
Practice Location Phone/Fax
| Phone: | 9702569424 |
| Fax: |
Provider Mailing Location
2835 NORTH AVE
GRAND JUNCTION
CO
815014918
Provider Mailing Phone/Fax
| Phone: | 9702569424 |
| Fax: |