Individual
LAVONNE D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2826 W NORTHERN AVE, PHOENIX, AZ 85051-6626
(602) 995-3755
(602) 995-3759
Mailing address
36247 N 17TH AVE, PHOENIX, AZ 85086-6314
(623) 580-8341
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7651
AZ
Other
Enumeration date
09/27/2006
Last updated
07/09/2007
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