Individual
ROBERT DEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
28 CLINTON AVE STE 2, WINSLOW, ME 04901-7076
(207) 873-0904
(207) 873-0904
Mailing address
28 CLINTON AVE STE 2, WINSLOW, ME 04901-7076
(207) 873-0904
(207) 873-0904
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CR1063
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0425
ANTHEM BLUE CROSS BLUE SH
ME
Enumeration date
09/16/2006
Last updated
07/08/2007
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