NPI 1083820302

Jack J. Clark, D.C.P.C.

Organisation Chiropractor Fort Wayne, IN

Practice location

Address: 6015 E State Blvd, Fort Wayne, IN 46815-7638
Phone: (260) 486-1886

Authorised official

Name: Valerie Badiac
Title: Office Manager
Phone: (260) 486-1886

Registered specialties (2)

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence 08000717A (IN)

Other Chiropractor providers in Indiana →

Rehabilitation Chiropractor

Chiropractic Providers Taxonomy 111NR0400X Licence 08002245A (IN)

Registry record

NPI: 1083820302
Entity type: Organization
NPI issued: 15 May 2007
Record last updated: 27 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.