Organization
CLARK CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE JEFFREY CLARK DC (OWNER PRACTITIONER)
(425) 255-0427
Entity
Organization
Contact information
Practice address
17422 108TH AVE SE, 101, RENTON, WA 98055-5400
(425) 255-0427
(425) 255-1066
Mailing address
17422 108TH AVE SE #101, RENTON, WA 98055-5400
(425) 255-0427
(425) 255-1066
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2219
WA
Other
Enumeration date
03/27/2007
Last updated
05/13/2011
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