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Dr. Diane Marie Clark, DC
Chiropractor in Port Orange, Florida
NPI 1306994637

Diane Marie Clark is a Chiropractor based in Port Orange, FL. Diane Marie Clark practices in Port Orange, FL and has the professional credentials of DC. The NPI Number for Diane Marie Clark is 1306994637 and holds a License No. CH5971 (Florida).

The current practice location address for Diane Marie Clark is 4705 S Clyde Morris Blvd, Port Orange, FL and can be reached out via phone at 386-763-2728.

Location: 4705 S Clyde Morris Blvd, Port Orange, FL, 32129-4103
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Provider Profile Details
NPI Number
1306994637
Provider Name
Diane Marie Clark
Credential
DC
Provider Entity Type
Individual
Gender
Female
Address
4705 S Clyde Morris Blvd, Port Orange, FL, 32129-4103
Phone Number
386-763-2728
Fax Number
Provider Enumeration Date
01/05/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
22574 01 FL BCBS
P00706874 01 FL RAILROAD MEDICARE
001509400 05 FL
institution
Provider Business Practice Location Address Details
Address
4705 S Clyde Morris Blvd
City
State
Zip
32129-4103
Phone Number
386-763-2728
Fax Number
person
Provider Business Mailing Address Details
Address
4705 S Clyde Morris Blvd
City
State
Zip
32129-4103
Phone Number
386-763-2728
Fax Number
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
License No.
CH5971 (Florida)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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