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Individual

ROBERT J CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
69 WILLARD ST, QUINCY, MA 02169-1228
(617) 479-2400
(617) 479-2828
Mailing address
69 WILLARD ST, QUINCY, MA 02169-1228
(617) 479-2400
(617) 479-2828

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2111
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0022022
NHP
MA
01
351264
HARVARD PILGRIM
MA
01
792893
TUFTS
MA
01
Y36490
BC/BS
MA
Enumeration date
11/01/2006
Last updated
07/08/2007
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