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Individual

MISS AMIE C CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
351 PASCOE BLVD., SUITE. 106, BOWLING GREEN, KY 42104
(270) 843-1930
(866) 530-9599
Mailing address
351 PASCOE BLVD., STE.106, BOWLING GREEN, KY 42104
(270) 843-1930
(866) 530-9599

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4742
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000477912
ANTHEM
KY
05
85003341
KY
Enumeration date
06/05/2006
Last updated
07/07/2009
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