| NPI | 1992873350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL TERRY CLARK Owner 602-956-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |