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Organization
LAKE PLACID CHIROPRACTIC CLINIC, INC
Active
Organization
LAKE PLACID CHIROPRACTIC CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT T CLARK SR. D.C. (OWNER)
(863) 699-6824
Entity
Organization
Contact information
Practice address
2411 US HIGHWAY 27 S, SEBRING, FL 33870-4943
(863) 382-9632
(863) 382-9632
Mailing address
2411 US HIGHWAY 27 S, SEBRING, FL 33870-4943
(863) 382-9632
(863) 382-9632
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7378
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3814891-00
—
FL
01
—
55739
BC/BS
FL
Enumeration date
05/28/2009
Last updated
09/18/2009
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