Organization
CLARK CHIROPRACTIC, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB SCOTT CLARK D.C. (OWNER)
(337) 232-3353
Entity
Organization
Contact information
Practice address
854 KALISTE SALOOM RD STE C, LAFAYETTE, LA 70508-4367
(337) 232-3353
(337) 232-9304
Mailing address
854 KALISTE SALOOM RD STE C, LAFAYETTE, LA 70508-4367
(337) 232-3353
(337) 232-9304
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1322
LA
Other
Enumeration date
02/22/2007
Last updated
05/02/2008
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