Individual
DR. KIOFA ENEZ CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
3048 NAPIER AVE, MACON, GA 31204-3841
(478) 746-3116
(478) 746-2136
Mailing address
3048 NAPIER AVE, MACON, GA 31204-3841
(478) 746-3116
(478) 746-2136
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008765
GA
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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