Organization
PORTER & CLARK CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A CLARK DO (PARTNER)
(734) 379-9200
Entity
Organization
Contact information
Practice address
29100 GATEWAY BLVD, STE 100, FLAT ROCK, MI 48134-2764
(734) 379-9200
(734) 379-9229
Mailing address
29100 GATEWAY BLVD, STE 100, FLAT ROCK, MI 48134-2764
(734) 379-9200
(734) 379-9229
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
JF008106
MI
111N00000X
Chiropractor
Primary
MP004985
MI
111N00000X
Chiropractor
TC005814
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950H220980
BLUE CROSS
MI
Enumeration date
12/14/2006
Last updated
04/01/2009
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