Organization
CLARK CHIROPRACTIC AND WELLNESS CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAVIS (CREDENTIALING SPECIALTSTS)
(912) 484-3879
Entity
Organization
Contact information
Practice address
10725 ABERCORN ST APT 143, SAVANNAH, GA 31419-1441
(912) 996-0961
Mailing address
10725 ABERCORN ST APT 143, SAVANNAH, GA 31419-1441
(912) 996-0961
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR009974
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHIR009974
CHIROPRACTIC
GA
Enumeration date
05/02/2018
Last updated
06/16/2018
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