| NPI | 1053684498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL TERRY CLARK Owner/Physician 602-956-9595 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ AZ5729) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |