JACK J CLARK

FORT WAYNE, IN
NPI1902881014
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy111N00000X Chiropractor
(Licence: IN  08000717A)
Enumeration Date2005-12-12
Last Update Date2010-06-22
Business Address
Dr. JACK J CLARK D.C.
6015 E STATE BLVD
FORT WAYNE, IN 46815-7638
Phone number: 260-486-1886
Mailing Address
Dr. JACK J CLARK D.C.
6015 E STATE BLVD
FORT WAYNE, IN 46815-7638
Phone number: 260-486-1886
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