Individual
DR. TIMOTHY PATRICK CLARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
13209 CAROWINDS BLVD STE G, CHARLOTTE, NC 28273-6735
(704) 583-6129
Mailing address
31506 VILLA TERRACE, FORT MILL, SC 29715
(803) 548-2196
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2263
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0181L
BLUE CROSS BLUE SHIELD
NC
05
—
890826F
—
NC
01
—
NC2263
STATE LICENSE
NC
Enumeration date
11/08/2006
Last updated
07/08/2007
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