Individual
DR. DAVID MICHAEL CLARKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1675 N MAPLE GROVE RD, BOISE, ID 83704-6925
(208) 376-4940
(208) 376-6812
Mailing address
1675 N MAPLE GROVE RD, BOISE, ID 83704-6925
(208) 376-4940
(208) 376-6812
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
C378
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010151977
BLUE SHIELD
ID
01
—
C3787
BLUE CROSS OF IDAHO
ID
Enumeration date
10/18/2005
Last updated
07/09/2007
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