| Clark Chiropractic And Massage Ps | |
|
601 S Race St Ste C Port Angeles WA 98362-6400 | |
| (360) 452-7636 | |
| Not Available |
| Full Name | Clark Chiropractic And Massage Ps |
|---|---|
| Speciality | Clinic/Center |
| Location | 601 S Race St Ste C, Port Angeles, Washington |
| Authorized Official Name and Position | Dustin Clark (PRESIDENT) |
| Authorized Official Contact | 3604527636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Chiropractic And Massage Ps 601 S Race St Ste C Port Angeles WA 98362-6400 Ph: (360) 452-7636 | Clark Chiropractic And Massage Ps 601 S Race St Ste C Port Angeles WA 98362-6400 Ph: (360) 452-7636 |
| NPI Number | 1659783363 |
|---|---|
| Provider Enumeration Date | 05/29/2014 |
| Last Update Date | 05/29/2014 |
| Medicare PECOS PAC ID | 3779708995 |
|---|---|
| Medicare Enrollment ID | O20140702000540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659783363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CHIR.CH.60465702 (Washington) | Primary |
| Provider Name | Dustin Jareb Clark |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225449671 PECOS PAC ID: 4688899800 Enrollment ID: I20140702000606 |
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