Organization
BAC MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD P CLACK DO (OWNER / PHYSICIAN)
(937) 277-9371
Entity
Organization
Contact information
Practice address
5900 N MAIN ST STE 3, DAYTON, OH 45415-3106
(937) 277-9371
(937) 277-7734
Mailing address
5900 N MAIN ST STE 3, DAYTON, OH 45415-3106
(937) 277-9371
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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