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Individual

DR. BRIAN T CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
5175 MOORES MILL ROAD, HUNTSVILLE, AL 35811
(256) 859-0440
(256) 849-0388
Mailing address
5175 MOORES MILL ROAD, HUNTSVILLE, AL 35811
(256) 859-0440
(256) 859-0388

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
979
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051070543
BLUE CROSS&BLUE SHIELD
AL
Enumeration date
09/12/2006
Last updated
05/29/2015
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