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Individual

DR. TRACI D CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
224 N FAIRVIEW ROAD, ROCKY MOUNT, NC 27801
(252) 446-7246
(252) 446-5407
Mailing address
PO BOX 7353, ROCKY MOUNT, NC 27804
(252) 446-7246
(252) 446-5407

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2876
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89085PH
NC
Enumeration date
07/11/2006
Last updated
08/14/2007
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