Organization
CLARK FAMILY CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIE C CLARK D.C. (PRESIDENT)
(270) 843-1930
Entity
Organization
Contact information
Practice address
351 PASCOE BLVD., STE 106, BOWLING GREEN, KY 42104
(270) 843-1930
(860) 530-9599
Mailing address
351 PASCOE BLVD., SUITE 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
07/21/2009
Last updated
07/21/2009
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