| NPI | 1982809646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREY CLARK Billing Representative 760-749-7414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC0228350) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2020-08-22 |