Individual
MR. JORDAN BARTON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
1462 S 231ST LN, BUCKEYE, AZ 85326-6131
(623) 327-0931
Mailing address
1462 S 231ST LN, BUCKEYE, AZ 85326-6131
(623) 327-0931
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1347
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
644535
—
AZ
Enumeration date
07/11/2006
Last updated
07/08/2007
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