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Organization

JEFFERY A CLARK, DC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFERY ALLEN CLARK DC (PRESIDENT)
(248) 391-4600
Entity
Organization

Contact information

Practice address
2991 S BALDWIN RD, LAKE ORION, MI 48360-1665
(248) 391-4600
(248) 391-1910
Mailing address
2991 S BALDWIN RD, LAKE ORION, MI 48360-1665
(248) 391-4600
(248) 391-1910

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301006916
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143126777
MI
01
BLUE CROSS
BLUE CROSS MICHIGAN
MI
Enumeration date
08/21/2006
Last updated
12/21/2011
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