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Individual

MR. CHRISTOPHER RUSSELL CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
177 E HIGH ST, WAYNESBURG, PA 15370-1818
(724) 852-1777
(724) 852-1777
Mailing address
177 E HIGH ST, WAYNESBURG, PA 15370-1818
(724) 852-1777
(724) 852-1777

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC007628L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01666127
GROUP HIGHMARK BCBS
PA
05
1010082300001
PA
01
1134175474
INDIVIDUAL NPI NUMBER
PA
01
897504
INDIVIDUAL HIGHMARK BCBS
PA
Enumeration date
05/26/2006
Last updated
07/08/2007
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