What is Charles Clark's NPI number?

The NPI number assigned to this healthcare provider is 1003119272, enumerated as a individual on December 10, 2010.

Where is the provider located?

The provider is located at 16222 N 59TH AVE SUITE A100 GLENDALE, AZ 85306 and the phone number is (623) 334-4000.

What is the provider's specialty?

The provider's specialty is Chiropractor with taxonomy code 111N00000X.

CHARLES CLARK JR. D.C. - NPI 1003119272 - Chiropractor in Glendale, AZ

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About Charles Clark Jr. D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES CLARK JR. D.C. (NPI 1003119272) is an individual chiropractor in Glendale, Arizona, licensed in Arizona (7094) and active in the NPI registry since December 2010.

NPPES Registry Identity

NPI1003119272

Entity TypeIndividualMale

Primary Taxonomy111N00000X

Provider Legal NameCHARLES CLARK JR.Credential: D.C.

Location Address16222 N 59TH AVE, SUITE A100Glendale, AZ 85306-1705

Mailing Address16222 N 59th Ave, Suite A100Glendale, AZ 85306-1705 · (623) 334-4000 · Fax (623) 334-4400

Phone(623) 334-4000

Fax(623) 334-4400

Sole ProprietorNo

Enumeration DateDecember 10, 2010

Last NPPES UpdateFebruary 8, 2017

✔ NPI 1003119272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in AZ · 7094

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

16222 N 59TH AVE, Glendale, AZ 85306

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