Individual
DR. JEREMY R CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
100 N KENNEDY BLVD, VANDALIA, IL 62471-2314
(618) 531-1141
Mailing address
100 N KENNEDY BLVD, VANDALIA, IL 62471-2314
(618) 531-1141
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
IL038-009768
IL
Other
Enumeration date
03/08/2007
Last updated
06/03/2011
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