Individual
DR. JOHN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1300 BLACK HORSE PIKE, GLENDORA, NJ 08029-1308
(856) 939-8889
(856) 939-5057
Mailing address
1448 ELLIS MILL RD, MONROEVILLE, NJ 08343-2816
(856) 223-0194
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MC03097
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8013705
—
NJ
Enumeration date
06/03/2006
Last updated
03/13/2014
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