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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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