NPI 1003119272

Charles Clark, DC

Practitioner Chiropractor Glendale, AZ

Practice location

Address: 16222 N 59th Ave Suite A100, Glendale, AZ 85306-1705
Phone: (623) 334-4000
Fax: (623) 334-4400

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence 7094 (AZ)

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Registry record

NPI: 1003119272
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Dec 2010
Record last updated: 8 Feb 2017

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.