Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Clark Mantooth

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1710737770

Clark Mantooth is a Student in an Organized Health Care Education/Training Program in Nellis AFB, Nevada. Licensed in Virginia. Registered with an NPI since 2024.

Licensed in
VA
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Nellis AFB, NV

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Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence 102209624 (VA)
Military Health Care Provider Taxonomy 171000000X

Record details

NPI number1710737770
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 25, 2024
Last updated in NPPESMarch 5, 2026
Certification dateMarch 5, 2026

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