Individual
JESSICA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
109 RHOADES AVE, GREENVILLE, OH 45331-2625
(937) 548-3610
(937) 548-3615
Mailing address
109 RHOADES AVE, GREENVILLE, OH 45331-2625
(937) 548-3610
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4654
OH
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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