Clark, Tyler John

Clark, Tyler John is an sole proprietor health care provider with primary practice located at 940 Belmont St Food And Nutrition Services, Brockton MA 02301-5596. He recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as his primary health care specialty. Clark, Tyler John can be contacted via phone (774) 826-1439.

Contact Information

Primary practice address
940 Belmont St Food And Nutrition Services Brockton MA 02301-5596
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 3061 Massachusetts

Profile Details

NPI number 1639492523
LBN Legal business name Clark, Tyler John
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 5th, 2010
Last updated May 6th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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