Rachael L Clark, is a
Dietitian, Registered based in Eagle Mountain, Utah. Rachael L Clark is licensed to practice in Utah (license number 8471403) and her current practice location is
4095 E Pony Express Pkwy, Eagle Mountain, Utah. She can be reached at her office (for appointments etc.) via phone at
(801) 429-8037.
NPI number for Rachael L Clark is 1194403865 and her current mailing address is 6657 W Skip Rock Rd, South Jordan, Utah. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1194403865.
Healthcare Provider's Profile
| Full Name | Rachael L Clark |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 4095 E Pony Express Pkwy, Eagle Mountain, Utah |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1194403865
- Provider Enumeration Date: 07/11/2023
- Last Update Date: 07/11/2023
Medical Identifiers
Medical identifiers for Rachael L Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1194403865 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 133V00000X | Dietitian, Registered | 8471403 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Rachael L Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Rachael L Clark, 6657 W Skip Rock Rd, South Jordan, UT 84009-1754 Ph: (801) 865-9670 | Rachael L Clark, 4095 E Pony Express Pkwy, Eagle Mountain, UT 84005-5529 Ph: (801) 429-8037 |
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