Organization
CLARK CHIROPRACTIC CENTER, LLC
Active
Organization
CLARK CHIROPRACTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM F CLARK D.C. (PRESIDENT)
(860) 632-1668
Entity
Organization
Contact information
Practice address
154 WEST ST, SUITE E, CROMWELL, CT 06416-4400
(860) 632-1668
(860) 632-1672
Mailing address
154 WEST ST, SUITE E, CROMWELL, CT 06416-4400
(860) 632-1668
(860) 632-1672
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
001321
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050001321CT02
ANTHEM BLUE CROSS/BLUE SHIELD
CT
01
—
132100
CONNECTICARE
—
01
—
1397991
AIG
CT
01
—
1740360049
CHN NHD
—
01
—
44-04334
UNITED HEALTHCARE
—
01
—
4409341-002
CIGNA
CT
01
—
611244
AMERICAN CHIROPRACTIC NETWORK
—
01
—
7139035
AETNA
—
01
—
905871CONN
PHCS PRIVATE HEALTHCARE SYSTEMS
—
01
—
P2773574
OXFORD
—
01
—
U75980
LIBERTY MUTUTAL
—
Enumeration date
02/01/2012
Last updated
02/01/2012
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