Individual
CHARLES CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
16222 N 59TH AVE, SUITE A100, GLENDALE, AZ 85306-1705
(623) 334-4000
(623) 334-4400
Mailing address
16222 N 59TH AVE, SUITE A100, GLENDALE, AZ 85306-1705
(623) 334-4000
(623) 334-4400
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7094
AZ
Other
Enumeration date
12/10/2010
Last updated
02/08/2017
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