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Organization
PREMIERE SPINE AND SPORTS MEDICINE LLC
Active
Organization
PREMIERE SPINE AND SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER DAVID CLARK MD (OWNER/PHYSICIAN)
(252) 295-8685
Entity
Organization
Contact information
Practice address
13114 PENNSYLVANIA AVE, HAGERSTOWN, MD 21742-2741
(301) 800-7770
Mailing address
13114 PENNSYLVANIA AVE, HAGERSTOWN, MD 21742-3720
(301) 800-7770
(301) 800-7891
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
MD
Other
Enumeration date
06/15/2017
Last updated
11/21/2024
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